Individual
DR. VIJAY GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
28-06 BROADWAY, FAIR LAWN, NJ 07410
(201) 475-8940
Mailing address
45 E CHERYL RD, PINE BROOK, NJ 07058-9428
(973) 567-3043
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
25MA08578400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199036
—
NJ
Enumeration date
06/01/2007
Last updated
02/28/2019
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