Individual
MRS. NEENA R GUPTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
55 LAKE AVE N, DEPARTMENT OF PEDIATRICS, WORCESTER, MA 01655-0002
(774) 442-5695
(774) 443-7399
Mailing address
PO BOX 415348, BOSTON, MA 02241-0001
(800) 225-8885
(508) 334-1977
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD11111
RI
2080P0210X
Pediatric Nephrology Physician
Primary
242003
MA
2080P0210X
Pediatric Nephrology Physician
MD11111
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001370701
MEDICARE
MA
01
—
00137071
MEDICARE
MA
05
—
110083785A
—
MA
01
—
1203613
UNITED HEALTH
RI
01
—
241728
BLUE CROSS
RI
01
—
28463
NEIGHBORHOOD HEALTH PLAN
RI
01
—
410398
BLUE CHIP
RI
05
—
N655193
—
RI
Enumeration date
08/31/2006
Last updated
10/28/2020
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