Individual
DR. KOMAL GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
57 HIGHLAND AVE, 2ND FLOOR, SALEM, MA 01970-2141
(978) 354-2705
Mailing address
207 WASHINGTON ST, BROOKLINE, MA 02445-6866
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9678
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003388301
MEDICARE
MA
Enumeration date
09/07/2007
Last updated
10/13/2021
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