Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 252346 | NY |
Y | 111NI0900X | Internist | 252346 | NY |
N | 207RG0300X | Geriatric Medicine | 252346 | NY |
NPI | 1023192077 |
---|---|
Provider Name | Gayatri Gupta |
First Address | Mamaroneck, NY 10543-2406 |
Second Address | Chappaqua, NY 10514-1412 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 14/05/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H24133 | (02) |