Provider Demographics
NPI:1760402564
Name:NEPHROLOGY HYPERTENSION ASSOCIATES OF CNY,P.C.
Entity Type:Organization
Organization Name:NEPHROLOGY HYPERTENSION ASSOCIATES OF CNY,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SALIL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-410-6400
Mailing Address - Street 1:6846 BUCKLEY RD
Mailing Address - Street 2:
Mailing Address - City:NORTH SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4264
Mailing Address - Country:US
Mailing Address - Phone:315-410-6400
Mailing Address - Fax:315-410-6410
Practice Address - Street 1:6846 BUCKLEY RD
Practice Address - Street 2:
Practice Address - City:NORTH SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212-4264
Practice Address - Country:US
Practice Address - Phone:315-410-6400
Practice Address - Fax:315-410-6410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-21
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY175728207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY56035AMedicare UPIN