Organization
PREM K GUPTA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PREM K GUPTA MD (PRESIDENT OWNER)
(718) 633-4244
Entity
Organization
Contact information
Practice address
4709 FORT HAMILTON PKWY, BROOKLYN, NY 11219-2927
(718) 633-4244
(718) 437-1556
Mailing address
4709 FORT HAMILTON PKWY, BROOKLYN, NY 11219-2927
(718) 633-4244
(718) 437-1556
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
108782
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00192549
—
NY
Enumeration date
11/11/2005
Last updated
09/24/2007
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