Provider Demographics
NPI:1295017861
Name:GUPTA, SUKRITI (PSYD, MA)
Entity type:Individual
Prefix:DR
First Name:SUKRITI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:PSYD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 S SERVICE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2133
Mailing Address - Country:US
Mailing Address - Phone:646-580-2912
Mailing Address - Fax:
Practice Address - Street 1:200 S SERVICE RD STE 101
Practice Address - Street 2:
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2133
Practice Address - Country:US
Practice Address - Phone:646-580-2912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2025-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016052101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty