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General NPI Number Information
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NPI Number | 1437309051
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Entity Type | Organization
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Legal Business Name | ADITI GUPTA M D P A
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 10/29/2008
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Provider Practice Location Address
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Address Line | 250 STELTON RD SUITE # 3, LOR LYN PLAZA
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3285
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Country | US
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Telephone | 732-752-3355
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Fax | 831-536-1696
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Provider Business Mailing Address
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Address Line | 250 STELTON RD SUITE # 3, LOR LYN PLAZA
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City | PISCATAWAY
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State | NJ
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Zip | 08854-3285
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Country | US
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Telephone | 732-752-3355
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Fax | 831-536-1696
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADITI GUPTA
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Credential | MD
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Telephone | 732-752-3355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 25MA04120200
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License Number State | NJ
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