Individual
ASHUTOSH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 HOSPITAL RD, EAST PATCHOGUE, NY 11772-4870
(631) 475-7680
(631) 475-7683
Mailing address
250 PATCHOGUE YAPHANK RD, SUITE 3, EAST PATCHOGUE, NY 11772-4800
(631) 475-7680
(631) 475-7683
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
213960
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01944334
—
NY
Enumeration date
10/25/2006
Last updated
07/08/2007
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