Healthcare Provider Details

I. General information

NPI: 1427337534
Provider Name (Legal Business Name): NIHIT GUPTA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2011
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5913 STONES THROW WAY
LIBERTY TWP OH
45044-1505
US

IV. Provider business mailing address

5913 STONES THROW WAY
LIBERTY TWP OH
45044-1505
US

V. Phone/Fax

Practice location:
  • Phone: 814-591-7902
  • Fax:
Mailing address:
  • Phone: 814-959-1379
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26801
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35.143982
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number26801
License Number StateWV
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberRL 11899
License Number StateND
# 5
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number57779
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: