1902891393 NPI number — RAJESH GUPTA MD

Table of content: RAJESH GUPTA MD (NPI 1902891393)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902891393 NPI number — RAJESH GUPTA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUPTA
Provider First Name:
RAJESH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902891393
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 E MAIN ST
Provider Second Line Business Mailing Address:
NORTHERN WESTCHESTER HOSPITAL -MEDICAL AFFAIRS OFFICE
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-3417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-242-8319
Provider Business Mailing Address Fax Number:
914-666-1965

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E MAIN ST
Provider Second Line Business Practice Location Address:
NORTHERN WESTCHESTER HOSPITAL - EMERGENCY DEPARTMENT
Provider Business Practice Location Address City Name:
MOUNT KISCO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10549-3417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-666-1254
Provider Business Practice Location Address Fax Number:
914-666-1931
Provider Enumeration Date:
09/13/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  197245 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 796337 . This is a "MVP PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7670434 . This is a "AETNA PPO PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1004537 . This is a "CDPHP PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2402Q1 . This is a "BCBS PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1241875 . This is a "AETNA HMO PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5C4628 . This is a "HEALTHNET PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 60412000012 . This is a "FIDELIS CARE PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3664800 . This is a "OXFORD PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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