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General NPI Number Information
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NPI Number | 1194794305
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Entity Type | Individual
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Provider Name | SANDEEP GUPTA M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 3594 E TREMONT AVE EAST TREMONT URGENT MEDICAL CARE
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City | BRONX
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State | NY
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Zip | 10465-2032
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Country | US
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Telephone | 718-597-5800
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Fax | 718-829-4118
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Provider Business Mailing Address
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Address Line | PO BOX 1012 EAST TREMONT URGENT MEDICAL CARE
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City | BRONX
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State | NY
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Zip | 10465-0612
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Country | US
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Telephone | 718-597-5800
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Fax | 718-829-4118
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 212451
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License Number State | NY
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