1033747340 NPI number — DR. AKSHITA GUPTA MD

Table of content: DR. AKSHITA GUPTA MD (NPI 1033747340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033747340 NPI number — DR. AKSHITA GUPTA MD

Organization/Personal Information

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

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:
1033747340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/08/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
12/08/2020
NPI Reactivation Date:
12/08/2020

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SHIVALIK MALVIYANAGAR
Provider Second Line Business Mailing Address:
HOUSE NO. A-103
Provider Business Mailing Address City Name:
NEW DELHI
Provider Business Mailing Address State Name:
DELHI
Provider Business Mailing Address Postal Code:
110017
Provider Business Mailing Address Country Code:
IN
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 FRUIT STREET, GRAY-BIGELOW BUILDING 7
Provider Second Line Business Practice Location Address:
ROOM 746
Provider Business Practice Location Address City Name:
BOSTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02114-2696
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-643-8949
Provider Business Practice Location Address Fax Number:
617-643-6443
Provider Enumeration Date:
03/31/2020

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com