Gupta, Rom M

Gupta, Rom M is an sole proprietor health care provider with primary practice located at 17561 Hillside Ave Ste 402 , Jamaica NY 11432-5769. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Gupta, Rom M can be contacted via phone (718) 291-0488.

Contact Information

Primary practice address
17561 Hillside Ave Ste 402 Jamaica NY 11432-5769
Fax: (718) 291-0888
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 189770 New York
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 189770 New York

Profile Details

NPI number 1013992528
LBN Legal business name Gupta, Rom M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 7th, 2005
Last updated Nov 4th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013992528 NPPES
New York MEDICAID 01417876

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