=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629101613
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YKG MEDICAL P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/13/2007
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 HOOSICK ST STE A
-----------------------------------------------------
City | TROY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12180-2393
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-459-0711
-----------------------------------------------------
Fax | 518-275-0646
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5 SAND CREEK RD STE 200
-----------------------------------------------------
City | ALBANY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12205-1400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-459-0711
-----------------------------------------------------
Fax | 518-275-0646
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MR. YOGESH KUMAR GUPTA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 518-459-0711
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | 144890
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------