Individual
GAURAV GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
150 E MANNING ST, PROVIDENCE, RI 02906-5109
(401) 272-2020
(401) 421-5979
Mailing address
150 E MANNING ST, PROVIDENCE, RI 02906-5109
(401) 272-2020
(401) 421-5979
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD12949
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366559114
NPI NUMBER
RI
01
—
MD12949
RI LICENCE NUMBER
RI
Enumeration date
08/25/2006
Last updated
10/23/2020
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