Basic Information
| Provider Information | |||||||||
| NPI: | 1699117101 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | GUPTA | ||||||||
| FirstName: | SAMEER | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2201 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115541859 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2201 HEMPSTEAD TPKE | ||||||||
| Address2: | |||||||||
| City: | EAST MEADOW | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115541859 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5165726703 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2013 | ||||||||
| LastUpdateDate: | 11/02/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/02/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 036135491 | IL | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | S7671 | TX | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | 036135491 | IL | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 282N00000X | N | Hospitals | General Acute Care Hospital | 208G00000X | S7671 | TX | Y | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
No ID Information.