Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 265081 | NY |
N | 207VX0000X | Obstetrician | 265081 | NY |
NPI | 1023271004 |
---|---|
Provider Name | Dr. Adeeti Gupta |
First Address | Middle Village, NY 11379 |
Second Address | Middle Village, NY 11379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 24/08/2017 |