Individual
DR. GLORIA GRACE GUPTILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
250 DELAWARE AVE, DELMAR, NY 12054-1420
(518) 439-8077
(518) 439-8070
Mailing address
711 TROY SCHENECTADY RD, SUITE 201, LATHAM, NY 12110-2442
(518) 213-0478
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
256529
NY
390200000X
Student in an Organized Health Care Education/Training Program
62714
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03349772
—
NY
Enumeration date
06/06/2008
Last updated
08/02/2011
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