Provider Demographics
NPI:1538199880
Name:KINGRA, GURPAL S (MD)
Entity type:Individual
Prefix:DR
First Name:GURPAL
Middle Name:S
Last Name:KINGRA
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:PO BOX 369
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01086-0369
Mailing Address - Country:US
Mailing Address - Phone:413-509-1000
Mailing Address - Fax:413-509-1003
Practice Address - Street 1:70 COURT ST
Practice Address - Street 2:SUITE 7 WESTFIELD MEDICAL CORPORATION
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085
Practice Address - Country:US
Practice Address - Phone:413-568-2801
Practice Address - Fax:413-572-9177
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36798207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H21061OtherBLUE CROSS
MA2017741Medicaid
A55625Medicare UPIN
MAH21061Medicare PIN
P00060900Medicare PIN