Provider Demographics
NPI:1821238676
Name:GUPTA, GUNJAN (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GUNJAN
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:GUNJAN
Other - Middle Name:
Other - Last Name:GUPTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, PHD
Mailing Address - Street 1:24 HOSPITAL AVE
Mailing Address - Street 2:DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-6099
Mailing Address - Country:US
Mailing Address - Phone:973-864-4418
Mailing Address - Fax:
Practice Address - Street 1:24 HOSPITAL AVE
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY AND LABORATORY MEDICINE
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-6099
Practice Address - Country:US
Practice Address - Phone:203-739-6471
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT52359207ZP0102X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology