Doctor Name: | DR. VIPAN KUMAR GUPTA |
NPI Number: | 1871588988 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 25MA06594200 |
Business Practice Address: | 718 Teaneck Rd Department Of Practice Management Teaneck, NJ - 076664245 |
Business Phone Number: | 2018337265 |
Business Fax Number: | 2018816295 |
Mailing Address: | 718 Teaneck Rd, Dept Of Practice Management TEANECK |
State: | NJ |
Postal Code: | 076664245 |
Phone Number: | 2018333000 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2005 |
NPI Last Update Date: | 02/28/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA06594200 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |