Provider Demographics
NPI:1013165935
Name:GUPTA, RUCHI (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 N 17TH ST
Mailing Address - Street 2:SUITE 309
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-5034
Mailing Address - Country:US
Mailing Address - Phone:610-437-6687
Mailing Address - Fax:
Practice Address - Street 1:401 N 17TH ST
Practice Address - Street 2:SUITE 309
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-5034
Practice Address - Country:US
Practice Address - Phone:610-437-6687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4292722080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology