Provider Demographics
NPI:1538681457
Name:GUPTA, RAHUL
Entity Type:Individual
Prefix:
First Name:RAHUL
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:LEHIGH VALLEY HEALTH NETWORK
Mailing Address - Street 2:PO BOX 689
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18105-1556
Mailing Address - Country:US
Mailing Address - Phone:610-402-3110
Mailing Address - Fax:
Practice Address - Street 1:LEHIGH VALLEY PHYSICIANS PRACTICE
Practice Address - Street 2:1250 S. CEDAR CREST BLVD, STE. 300
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103
Practice Address - Country:US
Practice Address - Phone:610-402-3110
Practice Address - Fax:610-402-3112
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT219672207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease