Dr. Rom M Gupta
Internist Gastroenterologist
17561 Hillside Ave Ste 402
Jamaica
, New York 11432-5769
Dr. Rom M Gupta
Internist Gastroenterologist
17561 Hillside Ave Ste 402
Jamaica
, New York 11432-5769
(718) 291-0888
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About
Features
Specialties
- Internist
- Gastroenterologist
Languages spoken
- English
Location
First Address
- Dr. Rom M Gupta
- 17561 Hillside Ave Ste 402
- Jamaica, NY
- Zip : 11432-5769
- Fax : (718) 291-0888
- Phone : (718) 291-0488
Second Address
- Dr. Rom M Gupta
- 17561 Hillside Ave Ste 402
- Jamaica, NY
- Zip : 11432-5769
- Fax : (718) 291-0888
- Phone : (718) 291-0488
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207R00000X | Internist | 189770 | NY |
| N | 111NI0900X | Internist | 189770 | NY |
| Y | 207RG0100X | Gastroenterologist | 189770 | NY |
National Provider Identifier
| NPI | 1013992528 |
|---|---|
| Provider Name | Dr. Rom M Gupta |
| First Address | Jamaica, NY 11432-5769 |
| Second Address | Jamaica, NY 11432-5769 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/12/2005 |
| Last Update Date | 04/11/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 01417876 | (05) | NY |
| F39166 | (02) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.