1275526493 NPI number — DR. KRISHNA GOPAL GUPTA MD

Table of content: DR. KRISHNA GOPAL GUPTA MD (NPI 1275526493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275526493 NPI number — DR. KRISHNA GOPAL GUPTA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUPTA
Provider First Name:
KRISHNA
Provider Middle Name:
GOPAL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275526493
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
251 7TH ST
Provider Second Line Business Mailing Address:
SUITE C202
Provider Business Mailing Address City Name:
NEW KENSINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15068-6534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-337-8404
Provider Business Mailing Address Fax Number:
724-337-4200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
251 7TH ST
Provider Second Line Business Practice Location Address:
SUITE C202
Provider Business Practice Location Address City Name:
NEW KENSINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-6534
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-337-8404
Provider Business Practice Location Address Fax Number:
724-337-4200
Provider Enumeration Date:
08/23/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208800000X , with the licence number:  MD020901E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1008641 . This is a "GATEWAY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94179 . This is a "HEALTH AMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000064297 . This is a "MEDPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000064297 . This is a "THREE RIVERS HEALTH PL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000039578 . This is a "HIGHMARK BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000039578 . This is a "PA BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 77801 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: C28368 . This is a "UPMC FOR YOU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0000039578 . This is a "KEYSTONE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94179 . This is a "HEALTH AMERICA ADVANTR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0006815760003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 206878 . This is a "UPMC HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 94179 . This is a "HEALTH ASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 25121574200 . This is a "OHIO BUREAU OF WORKERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1061214 . This is a "WV WORKMENS" identifier . This identifiers is of the category "OTHER".




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