Provider Demographics
NPI:1023324555
Name:GUPTA, ANKIT
Entity type:Individual
Prefix:
First Name:ANKIT
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 WASHINGTON ST STE 430
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2700
Mailing Address - Country:US
Mailing Address - Phone:860-886-1862
Mailing Address - Fax:860-886-2046
Practice Address - Street 1:79 WAWECUS ST STE 103
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2173
Practice Address - Country:US
Practice Address - Phone:860-886-1862
Practice Address - Fax:860-886-2046
Is Sole Proprietor?:No
Enumeration Date:2010-08-21
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT54594207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease