Provider Demographics
NPI:1225080278
Name:GUPTA, TARUN K (MD)
Entity Type:Individual
Prefix:DR
First Name:TARUN
Middle Name:K
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:115 TECHNOLOGY DR
Mailing Address - Street 2:STE B-106
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6337
Mailing Address - Country:US
Mailing Address - Phone:203-452-1411
Mailing Address - Fax:203-452-1412
Practice Address - Street 1:115 TECHNOLOGY DR
Practice Address - Street 2:SUITE B-106
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-1395
Practice Address - Country:US
Practice Address - Phone:203-452-1411
Practice Address - Fax:203-452-1412
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT32684207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001326843Medicaid
CT032684OtherCONNECTICARE
CT0V6284OtherHEALTHNET
CTP653628OtherOXFORD
CT010032684CT05OtherBLUE CROSS
CT2185309009OtherCIGNA
CT100000302Medicare ID - Type Unspecified
CTF54664Medicare UPIN