Provider Demographics
NPI:1770612962
Name:GUPTE, MEENAL A (MD FAAP)
Entity type:Individual
Prefix:DR
First Name:MEENAL
Middle Name:A
Last Name:GUPTE
Suffix:
Gender:F
Credentials:MD FAAP
Other - Prefix:
Other - First Name:APPORVA
Other - Middle Name:A
Other - Last Name:GUPTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD FAAP
Mailing Address - Street 1:1717 FRANKLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2248
Mailing Address - Country:US
Mailing Address - Phone:609-788-8691
Mailing Address - Fax:609-927-6220
Practice Address - Street 1:322 SHORE RD
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2634
Practice Address - Country:US
Practice Address - Phone:609-927-1353
Practice Address - Fax:609-927-6220
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07274400208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics