Healthcare Provider Details

I. General information

NPI: 1578945531
Provider Name (Legal Business Name): NEHA GUPTA MBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

983135 NEBRASKA MEDICAL CTR
OMAHA NE
68198-2319
US

IV. Provider business mailing address

983135 NEBRASKA MEDICAL CTR
OMAHA NE
68198-3135
US

V. Phone/Fax

Practice location:
  • Phone: 402-559-3901
  • Fax:
Mailing address:
  • Phone: 402-559-5909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License NumberMD-48570
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number33511
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License Number33511
License Number StateNE
# 4
Primary TaxonomyN
Taxonomy Code207ZP0007X
TaxonomyMolecular Genetic Pathology (Pathology) Physician
License NumberMND-48570
License Number StateIA
# 5
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD-48570
License Number StateIA
# 6
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number33511
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: