Healthcare Provider Details
I. General information
NPI: 1629101613
Provider Name (Legal Business Name): YKG MEDICAL P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2007
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
147 HOOSICK ST STE A
TROY NY
12180-2393
US
IV. Provider business mailing address
5 SAND CREEK RD STE 200
ALBANY NY
12205-1400
US
V. Phone/Fax
- Phone: 518-459-0711
- Fax: 518-275-0646
- Phone: 518-459-0711
- Fax: 518-275-0646
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 144890 |
| License Number State | NY |
VIII. Authorized Official
Name: MR.
YOGESH
KUMAR
GUPTA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 518-459-0711