MEDICARE: FRANCIS LUPO PT,DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	050081	NY

General Provider Information

NPI Number	:	1811694888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCIS LUPO PT,DPT

Provider Business Mailing Address
First Line	:	36 SAVO LOOP
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-2742
Country	:	US
Telephone Number	:	347-782-1011
Fax Number	:

Provider Business Practice Location Address
First Line	:	1243 WOODROW RD STE 323
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10309-1725
Country	:	US
Telephone Number	:	718-966-0111
Fax Number	:	718-966-0087

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2023
Last Update Date	:	02/10/2023

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