1952585838 NPI number — DR. INDU GUPTA MD, MPH, MAPA

Table of content: DR. INDU GUPTA MD, MPH, MAPA (NPI 1952585838)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952585838 NPI number — DR. INDU GUPTA MD, MPH, MAPA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUPTA
Provider First Name:
INDU
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH, MAPA
Provider Gender Code:
F

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:
1952585838
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421 MONTGOMERY ST. ONONDAGA COUNTY HEALTH DEPARTMENT
Provider Second Line Business Mailing Address:
JOHN H. MULROY CIVIC CENTER 9TH FLOOR
Provider Business Mailing Address City Name:
SYRACUSE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-435-3155
Provider Business Mailing Address Fax Number:
315-435-5720

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 ATWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COOPERSTOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13326-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-547-4625
Provider Business Practice Location Address Fax Number:
607-547-3259
Provider Enumeration Date:
12/27/2007

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: 207R00000X , with the licence number:  186651-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: C54706 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01274611 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com