Provider Demographics
NPI:1972824209
Name:GUPTA, PRIYA SARIN (MD)
Entity type:Individual
Prefix:DR
First Name:PRIYA
Middle Name:SARIN
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:111 BREWSTER ST
Mailing Address - Street 2:FCC C
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-4474
Mailing Address - Country:US
Mailing Address - Phone:401-729-2769
Mailing Address - Fax:401-729-2772
Practice Address - Street 1:111 BREWSTER ST
Practice Address - Street 2:FCC C
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-4474
Practice Address - Country:US
Practice Address - Phone:401-729-2769
Practice Address - Fax:401-729-2772
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RILP01951207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIRES-000Medicare UPIN