Healthcare Provider Details

I. General information

NPI: 1134381981
Provider Name (Legal Business Name): ASHWANI GUPTA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 11/20/2023
Certification Date: 11/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1205 LANGHORNE NEWTOWN RD STE 400
LANGHORNE PA
19047-1223
US

IV. Provider business mailing address

41 UNIVERSITY DR STE 300
NEWTOWN PA
18940-1873
US

V. Phone/Fax

Practice location:
  • Phone: 215-757-7212
  • Fax: 215-757-7274
Mailing address:
  • Phone: 215-710-5522
  • Fax: 215-710-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD464016
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: