Provider Demographics
NPI:1972586790
Name:SENGUPTA, PINAKI (MD)
Entity Type:Individual
Prefix:
First Name:PINAKI
Middle Name:
Last Name:SENGUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 N ROUTE 303
Mailing Address - Street 2:CONGERS PLAZA, UNIT 15
Mailing Address - City:CONGERS
Mailing Address - State:NY
Mailing Address - Zip Code:10920-1413
Mailing Address - Country:US
Mailing Address - Phone:845-268-7180
Mailing Address - Fax:845-268-8298
Practice Address - Street 1:285 N ROUTE 303
Practice Address - Street 2:CONGERS PLAZA, UNIT 15
Practice Address - City:CONGERS
Practice Address - State:NY
Practice Address - Zip Code:10920-1413
Practice Address - Country:US
Practice Address - Phone:845-268-7180
Practice Address - Fax:845-268-8298
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161424207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00968474Medicaid
NY00968474Medicaid
NY62X231Medicare ID - Type Unspecified