Healthcare Provider Details

I. General information

NPI: 1851532808
Provider Name (Legal Business Name): AMIT GUPTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2009
Last Update Date: 01/27/2023
Certification Date: 01/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 WASHINGTON RD
WEST POINT NY
10996-1109
US

IV. Provider business mailing address

900 WASHINGTON RD
WEST POINT NY
10996-1109
US

V. Phone/Fax

Practice location:
  • Phone: 845-938-3441
  • Fax: 253-237-9301
Mailing address:
  • Phone: 845-938-3441
  • Fax: 253-237-9301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD-14581
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD-14581
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD-14581
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: