Provider Demographics
NPI:1740894906
Name:GUPTA, NIDHI (MD)
Entity type:Individual
Prefix:DR
First Name:NIDHI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NIDHI
Other - Middle Name:
Other - Last Name:ARORA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 COMMUNITY DRIVE, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021
Mailing Address - Country:US
Mailing Address - Phone:646-714-5096
Mailing Address - Fax:
Practice Address - Street 1:225 COMMUNITY DRIVE, SUITE 110
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021
Practice Address - Country:US
Practice Address - Phone:516-918-4802
Practice Address - Fax:516-918-4839
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338414208000000X, 207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No208000000XAllopathic & Osteopathic PhysiciansPediatrics