Prem Prakash Gupta M.D P.C

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

140866 Issued in NY

Legal business name

PREM PRAKASH GUPTA M.D P.C

Practice address

39 Old Monticello Rd
Ferndale, NY 12734-5224

Phone

(845) 292-4560

Fax

(845) 292-4561

NPI assigned

Jun 23, 2006

Last updated

Oct 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Prem Prakash Gupta, M.DNPI 1295706281

Title

President

Phone

(845) 292-4560

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Prem P Gupta, MD

  • Neurology Physician
  • Ferndale, NY
  • NPI 1295706281
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1013943141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 OLD MONTICELLO RD",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127345224",
            "telephone_number": "845-292-4560",
            "fax_number": "845-292-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 OLD MONTICELLO RD",
            "city": "FERNDALE",
            "state": "NY",
            "postal_code": "127345224",
            "telephone_number": "845-292-4560",
            "fax_number": "845-292-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREM PRAKASH GUPTA M.D P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "PREM",
        "authorized_official_middle_name": "PRAKASH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-292-4560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "140866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00715242",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Pediatrics PC
• Diane Mary Monahan, LPN BSN
• Brian Keith Mungeer, D.C.,D.A.C.N.B.
• Yvonne Cynthia Newland Pagan, MD
• Joan Parvi, LPN
• David Schwalb, MD
• Michael E Schwartz, PSYD., MSCP.
• Devorah Schwebel, CCC-SLP
• Linda Rene Thompson, NP
• Dennis Waxman, PA

• Neurology Physician in Ferndale, NY
• Providers in Ferndale, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.