Provider Demographics
NPI:1386750255
Name:GUPTA, NARENDRA K (MD)
Entity type:Individual
Prefix:
First Name:NARENDRA
Middle Name:K
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:MARLBORO MEDICAL CENTER LLC
Mailing Address - Street 2:PLAZA 203 RTE 9 S
Mailing Address - City:ENGLISHTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726
Mailing Address - Country:US
Mailing Address - Phone:732-617-8800
Mailing Address - Fax:732-617-8808
Practice Address - Street 1:MARLBORO MEDICAL CENTER LLC
Practice Address - Street 2:PLAZA 203 RTE 9 S
Practice Address - City:ENGLISHTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07726
Practice Address - Country:US
Practice Address - Phone:732-617-8800
Practice Address - Fax:732-617-8808
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA065420207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7465156Medicaid
NJ7465156Medicaid
NJSNL851177Medicare ID - Type Unspecified