Individual ProviderAnjali GuptaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address17 E 102nd St, New York, NY 10029-5204(212) 659-8551(212) 987-3100PECOS EnrollmentBased on the most recent information from CMS, provider Anjali Gupta is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 6 days ago.Profile DetailsProvider ID1063695971Provider TypeIndividualFull NameGupta, AnjaliCredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date12/13/2007Last Updated12/3/2013Contact InformationPractice LocationPractice Address17 E 102nd St, New York, NY 10029-5204Phone(212) 659-8551Fax(212) 824-2317Mailing LocationMailing Address1 Gustave L Levy Pl, Box 3000, New York, NY 10029-6504Phone(212) 987-3100Fax(212) 731-5210Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense207510New YorkCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense25MA07665900New JerseyProvider IdentifiersIDDescriptionIssuerID095125UPADescriptionOtherIssuerMEDICARE INDIVIDUAL NUMNew Jersey