Individual
SHAIFALI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
190 WELLES ST, KINGSTON, PA 18704-4968
(570) 718-4140
(570) 718-4141
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD437698
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
162121
MEDICARE
PA
Enumeration date
05/18/2007
Last updated
08/10/2020
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