Healthcare Provider Details

I. General information

NPI: 1528195930
Provider Name (Legal Business Name): ALFRED A CUPELLI DR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5750 CENTRE AVENUE SUITE 310
PITTSBURGH PA
15206
US

IV. Provider business mailing address

101 DRAKE ROAD
PITTSBURGH PA
15241
US

V. Phone/Fax

Practice location:
  • Phone: 412-661-8255
  • Fax: 412-661-8229
Mailing address:
  • Phone: 412-831-3373
  • Fax: 412-831-3777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDS022861L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: