Individual
PUNITA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
840 S WOOD ST, CHICAGO, IL 60612-4325
(312) 996-6043
Mailing address
21 READ AVE, TUCKAHOE, NY 10707-3213
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MA09328300
NJ
390200000X
Student in an Organized Health Care Education/Training Program
125053691
IL
Other
Enumeration date
09/19/2007
Last updated
07/24/2013
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