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NPI Code Detail

MEDICARE: GUPTA GASTRO ASSOCIATE OFFICE BASED SURGERY, P.C.

MEDICARE: GUPTA GASTRO ASSOCIATE OFFICE BASED SURGERY, P.C.
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
1261QE0800XEndoscopy Clinic/Center148223NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1432552OTHERNYJOINT COMMISSION HEALTH CARE ORGANIZATION #

General Provider Information

NPI Number : 1497878581
Entity Type Code : Organization
Provider Name (Legal Business Name) : GUPTA GASTRO ASSOCIATE OFFICE BASED SURGERY, P.C.
Provider Business Mailing Address
First Line : 130 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-6362
Country : US
Telephone Number : 718-372-7434
Fax Number :
Provider Business Practice Location Address
First Line : 130 AVENUE P
Second Line :
City : BROOKLYN
State : NY
Zip : 11204-6362
Country : US
Telephone Number : 718-372-7434
Fax Number : 718-266-2663
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. NEVILLE GUPTA
Credential :
Telephone Number : 718-372-7434
Provider Enumeration Date : 04/06/2007
Last Update Date : 11/19/2009

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