Provider Demographics
NPI:1093782559
Name:GUPTA, YOGESH KUMAR (MD)
Entity type:Individual
Prefix:
First Name:YOGESH
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 WELLNESS WAY STE 201
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2156
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:147 HOOSICK ST STE A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:NY
Practice Address - Zip Code:12180-2393
Practice Address - Country:US
Practice Address - Phone:518-272-5080
Practice Address - Fax:518-272-5085
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2025-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY144890207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY07030369Medicaid
NY51471BMedicare ID - Type Unspecified
NY51471BMedicare ID - Type UnspecifiedMEDICARE NUMBER
NY07030369Medicaid