Provider Demographics
NPI:1669821245
Name:GUPTA, ANEESH (MD)
Entity type:Individual
Prefix:DR
First Name:ANEESH
Middle Name:
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 TOURNAMENT DR
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-3998
Mailing Address - Country:US
Mailing Address - Phone:856-906-6473
Mailing Address - Fax:
Practice Address - Street 1:2701 KIRKWOOD HWY STE B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-4911
Practice Address - Country:US
Practice Address - Phone:302-485-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1023988207V00000X
PAMD480916207V00000X
DEC1-0027504207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology