Provider Demographics
NPI:1003041088
Name:GUPTA, ANKUR (MD)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:226 E 29TH ST
Mailing Address - Street 2:APT 5D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8577
Mailing Address - Country:US
Mailing Address - Phone:646-621-7240
Mailing Address - Fax:718-343-7463
Practice Address - Street 1:226 E 29TH ST
Practice Address - Street 2:APT 5D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8577
Practice Address - Country:US
Practice Address - Phone:646-621-7240
Practice Address - Fax:718-343-7463
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0477252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology