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General NPI Number Information
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NPI Number | 1447509989
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Entity Type | Organization
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Legal Business Name | ADEETI GUPTA PHYSICIAN PC
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 7001 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2191
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Country | US
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Telephone | 917-410-6905
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Fax | 646-878-6095
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Provider Business Mailing Address
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Address Line | 7001 METROPOLITAN AVE
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City | MIDDLE VILLAGE
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State | NY
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Zip | 11379-2191
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Country | US
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Telephone | 917-410-6905
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Fax | 646-878-6095
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADEETI GUPTA
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Credential | MD
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Telephone | 516-652-3346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 265081
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License Number State |
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