Healthcare Provider Details

I. General information

NPI: 1538753876
Provider Name (Legal Business Name): CUPID MEDICAL PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2021
Last Update Date: 02/20/2024
Certification Date: 02/20/2024
Deactivation Date: 10/15/2023
Reactivation Date: 11/02/2023

III. Provider practice location address

8 THE GRN STE 11670
DOVER DE
19901-3618
US

IV. Provider business mailing address

8 THE GRN STE 11670
DOVER DE
19901-3618
US

V. Phone/Fax

Practice location:
  • Phone: 866-932-5104
  • Fax:
Mailing address:
  • Phone: 415-497-8417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HARRY DIFRANCESCO
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 866-932-5104