Healthcare Provider Details

I. General information

NPI: 1316510746
Provider Name (Legal Business Name): WALK IN GYN CARE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2021
Last Update Date: 02/17/2022
Certification Date: 02/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 S. ROBERTSON BLVD.
LOS ANGELES CA
90035
US

IV. Provider business mailing address

70-01, METROPOLITAN AVENUE
MIDDLE VILLAGE NY
11379
US

V. Phone/Fax

Practice location:
  • Phone: 917-410-6905
  • Fax: 646-878-6095
Mailing address:
  • Phone: 516-308-2392
  • Fax: 718-898-3190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ADEETI GUPTA
Title or Position: OWNER, CEO
Credential: M.D.
Phone: 516-308-2392