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NPI Code Detail

MEDICARE: MR. AMIT GUPTA R.PH

MEDICARE: MR. AMIT GUPTA R.PH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist28RI02783800NJ

General Provider Information

NPI Number : 1629109327
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. AMIT GUPTA R.PH
Provider Business Mailing Address
First Line : 5 PELHAM LN
Second Line :
City : BORDENTOWN
State : NJ
Zip : 08505-3143
Country : US
Telephone Number : 908-581-3103
Fax Number :
Provider Business Practice Location Address
First Line : 136 CENTRAL AVE
Second Line :
City : CLARK
State : NJ
Zip : 07066-1142
Country : US
Telephone Number : 732-574-9015
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2007
Last Update Date : 07/08/2007

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