Provider Demographics
NPI:1720150204
Name:GUPTA, ADARSH (MD)
Entity type:Individual
Prefix:
First Name:ADARSH
Middle Name:
Last Name:GUPTA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 NORTHERN BLVD STE 206
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5113
Mailing Address - Country:US
Mailing Address - Phone:516-684-9535
Mailing Address - Fax:516-684-9536
Practice Address - Street 1:560 NORTHERN BLVD STE 206
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5113
Practice Address - Country:US
Practice Address - Phone:516-684-9535
Practice Address - Fax:516-684-9536
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1962792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry