Provider Demographics
NPI:1437864311
Name:GUPTA, BHARTI
Entity Type:Individual
Prefix:
First Name:BHARTI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25156 RIDING CENTER DR
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20152-6049
Mailing Address - Country:US
Mailing Address - Phone:732-277-8100
Mailing Address - Fax:571-639-4695
Practice Address - Street 1:13011 W HIGHWAY 42 STE L04
Practice Address - Street 2:
Practice Address - City:PROSPECT
Practice Address - State:KY
Practice Address - Zip Code:40059-7166
Practice Address - Country:US
Practice Address - Phone:502-475-1349
Practice Address - Fax:571-639-4695
Is Sole Proprietor?:No
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide