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Individual

DR. MALA GUPTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D., F.I.A.C.

Contact information

Practice address
222 STATION PLZ N, SUITE 606, MINEOLA, NY 11501-3808
(516) 663-4533
(516) 663-8824
Mailing address
222 STATION PLZ N STE 606, MINEOLA, NY 11501-3893
(516) 663-4533
(516) 663-8824

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
187402
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
187402
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01630262
NY
Enumeration date
04/06/2006
Last updated
06/10/2010
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