Individual
DIVYA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7010
(732) 744-5873
Mailing address
65 JAMES ST, EDISON, NJ 08820-3947
(732) 321-7010
(732) 744-5873
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
25MA08156200
NJ
2084N0600X
Clinical Neurophysiology Physician
25MA08156200
NJ
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
25MA08156200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001401380
—
CT
05
—
0121622
—
NJ
01
—
130000567
UCHC, FARMINGTON, CT
—
01
—
130000575
ECHN, MANCHESTER, CT
—
Enumeration date
06/22/2005
Last updated
04/21/2022
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