Provider Demographics
NPI:1972591816
Name:GUPTA, SHALABH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SHALABH
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:394 E 8TH ST
Mailing Address - Street 2:APT #1-D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5393
Mailing Address - Country:US
Mailing Address - Phone:212-591-2590
Mailing Address - Fax:212-253-4251
Practice Address - Street 1:400 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4901
Practice Address - Country:US
Practice Address - Phone:212-263-6952
Practice Address - Fax:212-263-7146
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233036208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI19779Medicare UPIN
NY0726J1Medicare PIN