Individual
DR. SAURABH GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 COMMACK RD, COMMACK, NY 11725-5020
(631) 632-2428
Mailing address
PO BOX 1559, STONY BROOK, NY 11790-0989
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
036139724
IL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
296845
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2011
Last updated
09/23/2020
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