Provider Demographics
NPI:1427053933
Name:ARYA-GUPTA, KALPANA (MD)
Entity type:Individual
Prefix:
First Name:KALPANA
Middle Name:
Last Name:ARYA-GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KALPANA
Other - Middle Name:
Other - Last Name:ARYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:12 RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2752
Mailing Address - Country:US
Mailing Address - Phone:516-946-9555
Mailing Address - Fax:
Practice Address - Street 1:7517 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2638
Practice Address - Country:US
Practice Address - Phone:516-946-9555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-21
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202517207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01663249Medicaid
NY38A912Medicare ID - Type Unspecified
NY01663249Medicaid
G31140Medicare UPIN