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NPI Code Detail

MEDICARE: SHASHANK GUPTA DO

MEDICARE: SHASHANK GUPTA DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1861181299
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHASHANK GUPTA DO
Provider Business Mailing Address
First Line : 8 LILY DR
Second Line :
City : SOUTH SETAUKET
State : NY
Zip : 11720-2000
Country : US
Telephone Number : 516-286-3383
Fax Number :
Provider Business Practice Location Address
First Line : 1 COOPER PLZ
Second Line :
City : CAMDEN
State : NJ
Zip : 08103-1461
Country : US
Telephone Number : 856-342-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2023
Last Update Date : 06/13/2026

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Directions to “ SHASHANK GUPTA DO” Practice Location

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