Provider Demographics
NPI:1053318063
Name:GUPTA, JUHEE (MD)
Entity Type:Individual
Prefix:DR
First Name:JUHEE
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 -37 PROGRESS STREET, SUITE A1
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1102
Mailing Address - Country:US
Mailing Address - Phone:908-226-1500
Mailing Address - Fax:908-755-3200
Practice Address - Street 1:35-37 PROGRESS ST STE A1
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-1179
Practice Address - Country:US
Practice Address - Phone:908-226-1500
Practice Address - Fax:908-755-3200
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-05
Last Update Date:2007-07-09
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06083100207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223486440OtherTAX ID
NJ7053801Medicaid
NJ7053801Medicaid