Provider Demographics
NPI:1730390360
Name:GUPTA, CHITRA LEKHA (MD)
Entity type:Individual
Prefix:MRS
First Name:CHITRA
Middle Name:LEKHA
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WOODGATE LANE
Mailing Address - Street 2:
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-525-0257
Mailing Address - Fax:
Practice Address - Street 1:900 BUSINESS CENTER DRIVE
Practice Address - Street 2:QUEST DIAGNOSTICS INCORPORATED
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044
Practice Address - Country:US
Practice Address - Phone:215-444-8221
Practice Address - Fax:215-957-0563
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035152L207ZP0102X
DEC10008170207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F18674Medicare UPIN