Healthcare Provider Details

I. General information

NPI: 1093782559
Provider Name (Legal Business Name): YOGESH KUMAR GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
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

147 HOOSICK ST STE A
TROY NY
12180-2393
US

V. Phone/Fax

Practice location:
  • Phone: 518-272-5080
  • Fax: 518-272-5085
Mailing address:
  • Phone: 518-459-0711
  • Fax: 518-275-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number144890
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: