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Organization

GASTROENTEROLOGY SPECIALTY GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TARUN K GUPTA MD (PHYSICIAN)
(203) 452-1411
Entity
Organization

Contact information

Practice address
115 TECHNOLOGY DR, STE B-106, TRUMBULL, CT 06611-1395
(203) 452-1411
(203) 452-1412
Mailing address
115 TECHNOLOGY DR, STE B-106, TRUMBULL, CT 06611-1395
(203) 452-1411
(203) 452-1412

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
032684
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001326843
CT
01
010032684CT05
BC PROVIDER NUMBER
CT
01
032684
CONNECTICARE PROVIDER NUM
CT
01
110239944
MEDICARE RAILROAD PROV. #
CT
01
2185309009
CIGNA PROV. #
CT
01
5373649
AETNA PROVIDER #
CT
01
88411
US HEALTHCARE PROV. #
CT
01
OV6284
HEALTHNET PROV. #
CT
01
P653628
OXFORD PROVIDER NUMBER
CT
Enumeration date
06/02/2006
Last updated
04/07/2015
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