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General NPI Number Information
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NPI Number | 1205442688
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Entity Type | Organization
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Legal Business Name | SAURABH GUPTA MD LLC
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Dates
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Enumeration Date | 09/21/2020
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 410 FOULK RD STE 106
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City | WILMINGTON
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State | DE
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Zip | 19803-3835
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Country | US
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Telephone | 302-478-6100
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Fax | 302-295-3553
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Provider Business Mailing Address
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Address Line | 4 HUDSON WAY
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City | GARNET VALLEY
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State | PA
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Zip | 19060-1407
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Country | US
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Telephone | 302-276-3751
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Fax | 302-295-3553
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Authorized Official
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Title or Position | OWNER
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Name | SAURABH GUPTA
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Credential | MD
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Telephone | 302-478-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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