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General NPI Number Information
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NPI Number | 1548466402
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Entity Type | Organization
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Legal Business Name | GREAT NECK MEDICAL PSYCHIATRY ASSOCIATES, PC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 1010 NORTHERN BLVD SUITE 208D
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City | GREAT NECK
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State | NY
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Zip | 11021-5306
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Country | US
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Telephone | 516-336-2544
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Fax | 516-684-9536
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Provider Business Mailing Address
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Address Line | 1010 NORTHERN BLVD SUITE 208D
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City | GREAT NECK
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State | NY
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Zip | 11021-5306
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Country | US
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Telephone | 516-336-2544
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Fax | 516-684-9536
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADARSH K GUPTA
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Credential | MD
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Telephone | 516-336-2544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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