Individual
DR. SURENDRA KUMAR GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3435 70TH ST, JACKSON HEIGHTS, NY 11372-1055
(718) 651-9700
(718) 533-0264
Mailing address
1 HEMLOCK LN, ROSLYN HEIGHTS, NY 11577-2703
(516) 621-4296
(718) 533-0264
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
113450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00206111
—
NY
Enumeration date
01/03/2006
Last updated
07/08/2007
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