Healthcare Provider Details

I. General information

NPI: 1740298405
Provider Name (Legal Business Name): WESTCHESTER PUTNAM GASTROENTEROLOGY P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

667 STONELEIGH AVENUE SUITE A201
CARMEL NY
10512
US

IV. Provider business mailing address

667 STONELEIGH AVENUE SUITE A201
CARMEL NY
10512
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-5223
  • Fax: 845-278-4579
Mailing address:
  • Phone: 845-278-5223
  • Fax: 845-278-4579

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number147784
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number60205976
License Number StateNY
# 6
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SUNIL GUPTA
Title or Position: DIRECT OWNER
Credential: MD
Phone: 845-278-5223