MEDICARE: MEENU GUPTA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	231047	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184664179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEENU GUPTA M.D.

Provider Business Mailing Address
First Line	:	10555 62ND DR
Second Line	:	STE 1H
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1109
Country	:	US
Telephone Number	:	718-263-5251
Fax Number	:	718-849-3166

Provider Business Practice Location Address
First Line	:	10555 62ND DR
Second Line	:	STE 1H
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-1109
Country	:	US
Telephone Number	:	718-849-2723
Fax Number	:	718-849-3166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	04/14/2019

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Directions to “ MEENU GUPTA M.D.” Practice Location

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