Provider Demographics
NPI:1306991864
Name:GUPTA, NARINDER (MD)
Entity type:Individual
Prefix:
First Name:NARINDER
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2523
Mailing Address - Country:US
Mailing Address - Phone:504-362-7246
Mailing Address - Fax:504-362-1364
Practice Address - Street 1:120 TERRY PKWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-2523
Practice Address - Country:US
Practice Address - Phone:504-362-7246
Practice Address - Fax:504-362-1364
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD014743207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1305120Medicaid
LA1305120Medicaid
LA52400Medicare ID - Type Unspecified