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General NPI Number Information
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NPI Number | 1417229766
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Entity Type | Organization
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Legal Business Name | RAMIA GUPTA MD PC
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 02/02/2012
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Provider Practice Location Address
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Address Line | 411 1/2 N WASHINGTON ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-2311
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Country | US
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Telephone | 703-470-5844
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Fax |
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Provider Business Mailing Address
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Address Line | 5927 WILTON HILL TER
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City | ALEXANDRIA
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State | VA
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Zip | 22310-2336
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Country | US
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Telephone | 703-470-5844
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Fax |
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Authorized Official
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Title or Position | OWNWER
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Name | RAMIA GUPTA
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Credential | MD
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Telephone | 703-470-5844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | 0101249965
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License Number State | VA
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