Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 25MA06083100 | NJ |
NPI | 1053318063 |
---|---|
Provider Name | Dr. Juhee Gupta |
First Address | Edison, NJ 08820-1102 |
Second Address | Edison, NJ 08820-1179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
223486440 | TAX ID (01) | NJ |
7053801 | (05) | NJ |
G38845 | (02) | NJ |