Provider Demographics
NPI:1538502778
Name:GUPTA, ANJULI MARIE
Entity Type:Individual
Prefix:
First Name:ANJULI
Middle Name:MARIE
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 1:353 E 17TH ST
Mailing Address - Street 2:2ND FLOOR, ROOM 223
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-3821
Mailing Address - Country:US
Mailing Address - Phone:212-420-7343
Mailing Address - Fax:
Practice Address - Street 1:353 E 17TH ST
Practice Address - Street 2:2ND FLOOR, ROOM 223
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3821
Practice Address - Country:US
Practice Address - Phone:212-420-7343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-08
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program