Provider Demographics
NPI:1306364799
Name:YANTRA ENDOCRINOLOGY WELLNESS PC
Entity Type:Organization
Organization Name:YANTRA ENDOCRINOLOGY WELLNESS PC
Other - Org Name:YANTRA ENDOCRINOLOGY WELLNESS P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHITA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-759-9388
Mailing Address - Street 1:146 W 29TH ST STE 12E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5303
Mailing Address - Country:US
Mailing Address - Phone:646-759-9388
Mailing Address - Fax:
Practice Address - Street 1:146 W 29TH ST STE 12E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5303
Practice Address - Country:US
Practice Address - Phone:212-564-7981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-06
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264900207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty