Provider Demographics
NPI:1023271004
Name:GUPTA, ADEETI (MD)
Entity type:Individual
Prefix:DR
First Name:ADEETI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ADEETI GUPTA PHYSICIAN PC
Mailing Address - Street 2:66-83 70TH STREET
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379
Mailing Address - Country:US
Mailing Address - Phone:718-898-1170
Mailing Address - Fax:718-898-3190
Practice Address - Street 1:7001 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2191
Practice Address - Country:US
Practice Address - Phone:917-410-6905
Practice Address - Fax:646-878-6095
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY265081207VX0000X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
No207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY460667001OtherTIN