Individual
MADHAVI GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 MEDICAL CENTER BLVD, ACP #533, UPLAND, PA 19013-3902
(610) 874-1184
(610) 874-4258
Mailing address
221 S 12TH ST, APT. N607, PHILADELPHIA, PA 19107-5556
(646) 824-3906
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
MD422863
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1017194730
—
PA
Enumeration date
06/28/2006
Last updated
12/05/2007
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