Individual
DR. MANJU GUPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
332 LAFAYETTE AVENUE, HAWTHORNE, NJ 07506
(973) 423-0145
(973) 423-0667
Mailing address
332 LAFAYETTE AVENUE, HAWTHORNE, NJ 07506
(973) 423-0145
(973) 423-0667
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MA42995
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0898503
—
NJ
Enumeration date
07/06/2006
Last updated
08/09/2012
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