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General NPI Number Information
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NPI Number | 1497378467
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Entity Type | Organization
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Legal Business Name | NICKHIL GUPTA DO PC
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Dates
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Enumeration Date | 05/25/2020
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Last Update Date | 05/25/2020
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Provider Practice Location Address
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Address Line | 37 W CENTURY RD STE 106
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City | PARAMUS
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State | NJ
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Zip | 07652-1466
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Country | US
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Telephone | 800-750-8616
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Fax | 845-362-8474
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Provider Business Mailing Address
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Address Line | 26 FIREMENS MEMORIAL DR STE 115
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City | POMONA
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State | NY
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Zip | 10970-3569
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Country | US
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Telephone | 845-362-8400
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Fax | 845-362-8474
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Authorized Official
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Title or Position | OWNER
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Name | NICKHIL GUPTA
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Credential | MD
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Telephone | 800-750-8616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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