Provider First Line Business Practice Location Address:
ADEETI GUPTA PHYSICIAN PC
Provider Second Line Business Practice Location Address:
66-83 70TH STREET
Provider Business Practice Location Address City Name:
MIDDLE VILLAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11379
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-898-1170
Provider Business Practice Location Address Fax Number:
718-898-3190
Provider Enumeration Date:
07/09/2008