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Individual

DR. SANJEEV MOHAN GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
622 W 168TH ST PH 17, NEW YORK, NY 10032-3720
(212) 305-8509
Mailing address
622 W 168TH ST PH 17, NEW YORK, NY 10032-3720
(212) 305-8509

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD481815
PA
2080P0202X
Pediatric Cardiology Physician
25MA10853900
NJ
2080P0202X
Pediatric Cardiology Physician
Primary
290922
NY
2080P0202X
Pediatric Cardiology Physician
MD481815
PA

Other

Enumeration date
04/30/2014
Last updated
10/21/2025
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