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Individual

VIKRAM GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
246 CLIFTON AVE STE 4, CLIFTON, NJ 07011-1953
(973) 330-6765
(973) 939-8489
Mailing address
PO BOX 3399, WAYNE, NJ 07474-3399
(973) 330-6765
(973) 939-8489

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA08471700
NJ
208D00000X
General Practice Physician
25MA08471700
NJ

Other

Enumeration date
08/22/2008
Last updated
10/02/2012
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