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General NPI Number Information
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NPI Number | 1619437548
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Entity Type | Individual
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Provider Name | ALEXANDER JAY SCHUPPER MD
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Gender | Male
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Dates
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Enumeration Date | 03/25/2019
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Last Update Date | 03/25/2019
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Provider Practice Location Address
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Address Line | 1468 MADISON AVE FL 8
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City | NEW YORK
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State | NY
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Zip | 10029-6508
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Country | US
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Telephone | 212-241-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 412 SAYBROOK RD
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City | VILLANOVA
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State | PA
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Zip | 19085-1720
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Country | US
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Telephone | 610-527-3454
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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