Provider Demographics
NPI:1902891393
Name:GUPTA, RAJESH (MD)
Entity Type:Individual
Prefix:
First Name:RAJESH
Middle Name:
Last Name:GUPTA
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 1:400 E MAIN ST
Mailing Address - Street 2:NORTHERN WESTCHESTER HOSPITAL -MEDICAL AFFAIRS OFFICE
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3417
Mailing Address - Country:US
Mailing Address - Phone:914-242-8319
Mailing Address - Fax:914-666-1965
Practice Address - Street 1:400 E MAIN ST
Practice Address - Street 2:NORTHERN WESTCHESTER HOSPITAL - EMERGENCY DEPARTMENT
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3417
Practice Address - Country:US
Practice Address - Phone:914-666-1254
Practice Address - Fax:914-666-1931
Is Sole Proprietor?:No
Enumeration Date:2005-09-13
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY197245207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
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NYP3664800OtherOXFORD PIN
NY1004537OtherCDPHP PIN
NY2402Q1OtherBCBS PIN