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General NPI Number Information
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NPI Number | 1790803294
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Entity Type | Organization
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Legal Business Name | ALICJA GUPTA MDPC
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 21 MAYOR THOMAS J MCGRATH HWY SUITE 202
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City | QUINCY
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State | MA
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Zip | 02169-5351
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Country | US
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Telephone | 617-773-2709
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Fax | 617-479-4642
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Provider Business Mailing Address
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Address Line | 21 MAYOR THOMAS J MCGRATH HWY SUITE 202
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City | QUINCY
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State | MA
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Zip | 02169-5351
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Country | US
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Telephone | 617-773-2709
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Fax | 617-479-4642
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALICJA U GUPTA
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Credential | MD
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Telephone | 617-773-2709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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