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General NPI Number Information
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NPI Number | 1427409606
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Entity Type | Individual
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Provider Name | JYOTI GUPTA PT
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Gender | Female
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Dates
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Enumeration Date | 06/28/2016
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 122 PALMERS HILL RD
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City | STAMFORD
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State | CT
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Zip | 06902-2134
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Country | US
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Telephone | 203-323-2323
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Fax |
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Provider Business Mailing Address
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Address Line | 180 TURN OF RIVER RD UNIT 3A
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City | STAMFORD
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State | CT
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Zip | 06905-1396
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Country | US
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Telephone | 617-749-8592
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 008571
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License Number State | CT
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