Provider Demographics
NPI:1154456242
Name:JUHEE GUPTA MD PC
Entity Type:Organization
Organization Name:JUHEE GUPTA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JUHEE
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-226-1500
Mailing Address - Street 1:35-37 PROGRESS ST STE A1
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-1179
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2007-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06083100207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7053801Medicaid
NJG38845Medicare UPIN
NJ7053801Medicaid
NJ500409Medicare ID - Type Unspecified