Provider Demographics
NPI:1427266162
Name:GUPTA, NEERAJ (MS,RPH)
Entity type:Individual
Prefix:MR
First Name:NEERAJ
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MS,RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 HEATHWOOD DR
Mailing Address - Street 2:ALBEMARLE
Mailing Address - City:ALBEMARLE
Mailing Address - State:NC
Mailing Address - Zip Code:28001-5667
Mailing Address - Country:US
Mailing Address - Phone:646-416-1380
Mailing Address - Fax:
Practice Address - Street 1:1825 E MAIN ST
Practice Address - Street 2:ALBEMARLE
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5331
Practice Address - Country:US
Practice Address - Phone:704-986-0029
Practice Address - Fax:704-986-0038
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC18622183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist