Doctor Name: | DEBORAH A LUPO |
NPI Number: | 1043347164 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | F302409 |
Business Practice Address: | 3400 Nesconset Hwy Ste 101 East Setauket, NY - 117333327 |
Business Phone Number: | 6317518700 |
Business Fax Number: | 6317515971 |
Mailing Address: | 3400 Nesconset Hwy, Ste 101 EAST SETAUKET |
State: | NY |
Postal Code: | 117333327 |
Phone Number: | 6317518700 |
Fax Number: | 6317515971 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | F302409 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |