Provider Demographics
NPI:1316671589
Name:GUPTA, AARZOO
Entity type:Individual
Prefix:
First Name:AARZOO
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:SAINT VINCENT HOSPITAL, 123 SUMMER STREET
Mailing Address - Street 2:GRADUATE MEDICAL EDUCATION
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01608-2173
Mailing Address - Country:US
Mailing Address - Phone:508-363-5000
Mailing Address - Fax:
Practice Address - Street 1:SAINT VINCENT HOSPITAL, 123 SUMMER STREET
Practice Address - Street 2:GRADUATE MEDICAL EDUCATION
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01608-2173
Practice Address - Country:US
Practice Address - Phone:508-363-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA293726207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine