Provider Demographics
NPI:1205813391
Name:GUPTA, RAMESH C (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:C
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15-01 BROADWAY
Mailing Address - Street 2:SUITE 28
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-6003
Mailing Address - Country:US
Mailing Address - Phone:201-794-8900
Mailing Address - Fax:201-794-9424
Practice Address - Street 1:15-01 BROADWAY
Practice Address - Street 2:SUITE 28
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-6003
Practice Address - Country:US
Practice Address - Phone:201-794-8900
Practice Address - Fax:201-794-9424
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA029507207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1042665OtherHORIZON MERCY
NJBS066OtherOXFORD
NJ1301101Medicaid
NJOK5924OtherHEALTHNET
NJ12121OtherUHP
NJ0100009603OtherAMERICHOICE
NJ4092992OtherAETNA
NJ10994OtherAMERIGROUP
NJ0100009603OtherAMERICHOICE
NJ12121OtherUHP