Individual
CAROL L BAUM-GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
555 PROSPECT STREET, PAWTUCKET, RI 02860
(401) 729-6200
(401) 729-6203
Mailing address
111 BREWSTER STREET, WOOD BLDG #516, PAWTUCKET, RI 02860
Taxonomy
Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD12633
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002284501
MEDICARE PTAN
RI
05
—
CB85575
—
RI
Enumeration date
05/22/2008
Last updated
09/02/2011
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