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General NPI Number Information
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NPI Number | 1386368579
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Entity Type | Organization
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Legal Business Name | ASHISH GUPTA MD LLC
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 09/30/2022
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Provider Practice Location Address
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Address Line | 1033 GREENDALE AVE
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City | NEEDHAM
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State | MA
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Zip | 02492-4443
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Country | US
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Telephone | 617-794-6865
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Fax | 239-256-5654
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Provider Business Mailing Address
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Address Line | 1033 GREENDALE AVE
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City | NEEDHAM
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State | MA
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Zip | 02492-4443
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Country | US
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Telephone | 617-794-6865
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Fax | 239-256-5654
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Authorized Official
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Title or Position | MD
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Name | ASHISH GUPTA
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Credential |
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Telephone | 617-794-6865
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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