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General NPI Number Information
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NPI Number | 1699751917
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Entity Type | Individual
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Provider Name | LOUIS O PUPO M.D
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Gender | Male
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Dates
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Enumeration Date | 12/19/2005
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Last Update Date | 07/12/2019
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Provider Practice Location Address
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Address Line | 61 NEWTON SPARTA ROAD
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City | NEWTON
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State | NJ
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Zip | 07860
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Country | US
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Telephone | 973-726-7337
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Fax | 973-579-3071
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Provider Business Mailing Address
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Address Line | 61 NEWTON SPARTA ROAD
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City | NEWTON
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State | NJ
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Zip | 07860
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Country | US
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Telephone | 973-726-7337
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Fax | 973-579-3071
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MA046151
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License Number State | NJ
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