Provider Demographics
NPI:1275526493
Name:GUPTA, KRISHNA GOPAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISHNA
Middle Name:GOPAL
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:251 7TH ST
Mailing Address - Street 2:SUITE C202
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6534
Mailing Address - Country:US
Mailing Address - Phone:724-337-8404
Mailing Address - Fax:724-337-4200
Practice Address - Street 1:251 7TH ST
Practice Address - Street 2:SUITE C202
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6534
Practice Address - Country:US
Practice Address - Phone:724-337-8404
Practice Address - Fax:724-337-4200
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD020901E208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1008641OtherGATEWAY HEALTH PLAN
94179OtherHEALTH AMERICA
000000064297OtherMEDPLUS
000000064297OtherTHREE RIVERS HEALTH PL
0000039578OtherHIGHMARK BCBS
0000039578OtherPA BLUE SHIELD
77801OtherUS HEALTHCARE
C28368OtherUPMC FOR YOU
0000039578OtherKEYSTONE HEALTH PLAN
94179OtherHEALTH AMERICA ADVANTR
PA0006815760003Medicaid
206878OtherUPMC HEALTH PLAN
94179OtherHEALTH ASSURANCE
25121574200OtherOHIO BUREAU OF WORKERS
1061214OtherWV WORKMENS
1061214OtherWV WORKMENS
GU039578Medicare ID - Type Unspecified