Individual
DR. CHANDRA M GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 DOUGHTY BLVD, INWOOD, NY 11096-2003
(516) 239-2924
(516) 239-1609
Mailing address
101 DOUGHTY BLVD, INWOOD, NY 11096-2003
(516) 239-2924
(516) 239-1609
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
112347
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00203310
—
NY
Enumeration date
07/05/2005
Last updated
08/23/2010
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