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General NPI Number Information
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NPI Number | 1699745828
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Entity Type | Individual
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Provider Name | KAVITA GUPTA D.O.
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 705 WHITE HORSE RD STE D101
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City | VOORHEES
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State | NJ
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Zip | 08043-2468
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Country | US
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Telephone | 856-751-7799
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Fax | 856-751-6660
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Provider Business Mailing Address
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Address Line | PO BOX 3001
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City | VOORHEES
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State | NJ
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Zip | 08043-0598
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Country | US
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Telephone | 856-782-3300
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Fax | 856-504-8029
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MB07408300
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | MB07408300
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License Number State | NJ
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