MEDICARE: DOCSHAY1LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1972343051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCSHAY1LLC

Provider Business Mailing Address
First Line	:	62 HEMLOCK DR
Second Line	:
City	:	SLEEPY HOLLOW
State	:	NY
Zip	:	10591-1025
Country	:	US
Telephone Number	:	914-588-0330
Fax Number	:

Provider Business Practice Location Address
First Line	:	777 WHITE PLAINS RD STE 4A
Second Line	:
City	:	SCARSDALE
State	:	NY
Zip	:	10583-5022
Country	:	US
Telephone Number	:	914-588-0330
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. AKSHAY GUPTA
Credential	:	DO
Telephone Number	:	914-588-0330

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	05/28/2024

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