Provider Demographics
NPI:1821189218
Name:ARVIND K. GUPTA M.D. LLC
Entity Type:Organization
Organization Name:ARVIND K. GUPTA M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ARVIND
Authorized Official - Middle Name:K
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-878-6377
Mailing Address - Street 1:247 BROAD STREET
Mailing Address - Street 2:DR ARVIND GUPTA
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460
Mailing Address - Country:US
Mailing Address - Phone:203-878-3400
Mailing Address - Fax:203-876-0652
Practice Address - Street 1:247 BROAD STREET
Practice Address - Street 2:DR ARVIND GUPTA
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460
Practice Address - Country:US
Practice Address - Phone:203-878-3400
Practice Address - Fax:203-876-0652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2015-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT26375208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001222744Medicaid
CT001222744Medicaid
CT020001477Medicare ID - Type Unspecified