| Renu Gupta, M.d., P.c. | |
|
55 Mohawk St Suite 101 Cohoes NY 12047-2600 | |
| (518) 235-1119 | |
| Not Available |
| Full Name | Renu Gupta, M.d., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 55 Mohawk St, Cohoes, New York |
| Authorized Official Name and Position | Renu Gupta (OWNER) |
| Authorized Official Contact | 5182351119 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renu Gupta, M.d., P.c. Po Box 16091 Albany NY 12212-6091 Ph: (518) 459-0711 | Renu Gupta, M.d., P.c. 55 Mohawk St Suite 101 Cohoes NY 12047-2600 Ph: (518) 235-1119 |
| NPI Number | 1891914024 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4789662016 |
|---|---|
| Medicare Enrollment ID | O20040712001407 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891914024 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Renu Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942235213 PECOS PAC ID: 6103804430 Enrollment ID: I20040713000571 |
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