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General NPI Number Information
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NPI Number | 1467857870
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Entity Type | Organization
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Legal Business Name | ATLANTICARE
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Dates
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Enumeration Date | 10/28/2014
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Last Update Date | 10/28/2014
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Provider Practice Location Address
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Address Line | 1201 NEW RD STE 120
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City | LINWOOD
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State | NJ
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Zip | 08221-1152
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Country | US
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Telephone | 609-927-7070
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Fax | 609-927-7105
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Provider Business Mailing Address
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Address Line | 1201 NEW RD STE 120
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City | LINWOOD
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State | NJ
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Zip | 08221-1152
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Country | US
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Telephone | 609-927-7070
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Fax | 609-927-7105
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NAMITA GUPTA
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Credential | M.D.
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Telephone | 267-207-0237
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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 | 25MA09472900
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License Number State | NJ
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