Provider Demographics
NPI:1699784298
Name:GUPTA, ABHINAI KESAV (MD,MPH)
Entity type:Individual
Prefix:DR
First Name:ABHINAI
Middle Name:KESAV
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD,MPH
Other - Prefix:
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Mailing Address - Street 1:730 N BROAD ST
Mailing Address - Street 2:ST 101
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1796
Mailing Address - Country:US
Mailing Address - Phone:856-384-0238
Mailing Address - Fax:856-384-4788
Practice Address - Street 1:730 N BROAD ST
Practice Address - Street 2:ST 101
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1796
Practice Address - Country:US
Practice Address - Phone:856-384-0238
Practice Address - Fax:856-384-4788
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2016-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD433089207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEI47215Medicare UPIN