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General NPI Number Information
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NPI Number | 1225206790
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Entity Type | Individual
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Provider Name | DAVID A. PUPA L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 617 UNION AVE BUILDING 3 SUITE 13
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City | BRIELLE
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State | NJ
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Zip | 08730-1838
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Country | US
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Telephone | 732-256-4940
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Fax | 732-223-0388
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Provider Business Mailing Address
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Address Line | 2164 HIGHWAY 35 STE 6
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City | SEA GIRT
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State | NJ
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Zip | 08750-1013
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Country | US
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Telephone | 732-256-4940
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Fax | 732-223-0388
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC05335400
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License Number State | NJ
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