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Individual

DR. SURESH KUMAR GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
300 CENTRAL AVE, EAST ORANGE, NJ 07018-2819
(973) 266-4444
(973) 266-2932
Mailing address
4567 CROSSROADS PARK DRIVE, LIVERPOOL, NY 13088-3589
(315) 434-9309
(315) 454-0136

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
217303-1
NY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
25MA04299600
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91082984D
NJ
Enumeration date
07/24/2006
Last updated
02/10/2009
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