Healthcare Provider Details

I. General information

NPI: 1124965744
Provider Name (Legal Business Name): PAYEL GUPTA MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2026
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

586 PRESIDENT ST
BROOKLYN NY
11215-2034
US

IV. Provider business mailing address

419 CARLTON AVE APT B
BROOKLYN NY
11238-3859
US

V. Phone/Fax

Practice location:
  • Phone: 929-445-0991
  • Fax: 517-201-2009
Mailing address:
  • Phone: 517-449-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: PAYEL GUPTA
Title or Position: OWNER
Credential: MD
Phone: 929-445-0991