Individual
GEETA GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
637 RIVER AVENUE, LAKEWOOD, NJ 08701
(732) 886-9101
(732) 886-9523
Mailing address
637 RIVER AVENUE, LAKEWOOD, NJ 08701
(732) 886-9101
(732) 886-9523
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA65293
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7954000
—
NJ
Enumeration date
08/12/2006
Last updated
07/08/2010
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