Provider Demographics
NPI:1073096186
Name:GUPTA, AMIT KUMAR (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:KUMAR
Last Name:GUPTA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 OXFORD ROAD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380
Mailing Address - Country:US
Mailing Address - Phone:484-883-7597
Mailing Address - Fax:
Practice Address - Street 1:101 WALLACE AVE
Practice Address - Street 2:
Practice Address - City:DOWNINGTOWN
Practice Address - State:PA
Practice Address - Zip Code:19335-2604
Practice Address - Country:US
Practice Address - Phone:610-873-4725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP451610183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist