Healthcare Provider Details

I. General information

NPI: 1043264047
Provider Name (Legal Business Name): SALIL GUPTA M. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 07/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 UNIVERSITY PL 8TH FLOOR
NEW YORK NY
10003-4515
US

IV. Provider business mailing address

95 UNIVERSITY PL 8TH FLOOR
NEW YORK NY
10003-4515
US

V. Phone/Fax

Practice location:
  • Phone: 212-400-6633
  • Fax: 212-604-1379
Mailing address:
  • Phone: 212-400-6633
  • Fax: 212-604-1379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number218753
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: