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General NPI Number Information
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NPI Number | 1306364799
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Entity Type | Organization
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Legal Business Name | YANTRA ENDOCRINOLOGY WELLNESS PC
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Dates
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Enumeration Date | 09/06/2017
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 146 W 29TH ST STE 12E
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City | NEW YORK
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State | NY
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Zip | 10001-5303
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Country | US
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Telephone | 212-564-7981
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Fax |
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Provider Business Mailing Address
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Address Line | 146 W 29TH ST STE 12E
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City | NEW YORK
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State | NY
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Zip | 10001-5303
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Country | US
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Telephone | 646-759-9388
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. ASHITA GUPTA
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Credential |
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Telephone | 646-759-9388
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 264900
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License Number State | NY
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