Provider Demographics
NPI:1043411408
Name:GUPTA, MEENAKSHI (MD)
Entity type:Individual
Prefix:DR
First Name:MEENAKSHI
Middle Name:
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5501 OLD YORK RD
Mailing Address - Street 2:KORMAN BUILDING SUITE 202
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19141-3018
Mailing Address - Country:US
Mailing Address - Phone:215-254-2695
Mailing Address - Fax:215-456-5926
Practice Address - Street 1:609 W GERMANTOWN PIKE
Practice Address - Street 2:BRAEME BUILDING SUITE 270
Practice Address - City:EAST NORRITON
Practice Address - State:PA
Practice Address - Zip Code:19403-4243
Practice Address - Country:US
Practice Address - Phone:484-622-7100
Practice Address - Fax:484-622-7121
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2013-09-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDMD0367722084N0400X
MA2384872084N0400X
PAMD435843282N00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No282N00000XHospitalsGeneral Acute Care Hospital