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Individual

BRIJENDRA KUMAR GUPTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6713 LINCOLN AVENUE, LOCKPORT, NY 14094
(716) 433-0531
(716) 433-8446
Mailing address
6713 LINCOLN AVENUE, LOCKPORT, NY 14094
(716) 433-0531
(716) 433-8446

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
141063
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010070501
UNIVERA
01
000508042001
BCBS OF WNY
05
00627069
NY
01
0109980
INDEPENDENT HEALTH
Enumeration date
03/03/2006
Last updated
03/12/2010
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