Individual
SUSHILKUMAR SATISH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 DATES DR STE 310, ITHACA, NY 14850-1345
(267) 368-1169
Mailing address
201 DATES DR STE 310, ITHACA, NY 14850-1345
(267) 368-1169
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
300838
NY
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
300838
NY
207RP1001X
Pulmonary Disease Physician
Primary
25MA11662000
NJ
207RP1001X
Pulmonary Disease Physician
303838
NY
Other
Enumeration date
07/23/2014
Last updated
06/26/2023
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