Individual
KSHITIJ GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 SALEM ST STE 2, WILMINGTON, MA 01887-1200
(978) 664-1990
Mailing address
PO BOX 24532, NEW YORK, NY 10087-4532
(781) 744-8771
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
1020920
MA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
E10045
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E-10045
AR STATE LICENSE
AR
Enumeration date
11/02/2015
Last updated
07/30/2025
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