Provider Demographics
NPI:1578030607
Name:GUPTA, SHARMISHTHA
Entity Type:Individual
Prefix:
First Name:SHARMISHTHA
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 29TH ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2568
Mailing Address - Country:US
Mailing Address - Phone:909-971-7665
Mailing Address - Fax:
Practice Address - Street 1:3272 STEINWAY ST FL 5
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-4182
Practice Address - Country:US
Practice Address - Phone:347-609-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor