| Organization Name: | SANJEEV AND MUKTA GUPTA |
| NPI Number: | 1245253830 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SANJEEV GIPTA (OWNER) |
| Mailing Address: | 31 Hospital Dr Massena |
| State: | NY US |
| Postal Code: | 13662 |
| Phone Number: | 3157691099 |
| Fax Number: | 3157691077 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | 226022 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |