MEDICARE: MICHELE CUPID

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1275114019
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELE CUPID

Provider Business Mailing Address
First Line	:	3321 BAYCHESTER AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-2621
Country	:	US
Telephone Number	:	646-633-8058
Fax Number	:

Provider Business Practice Location Address
First Line	:	1401 EDWARD L GRANT HWY
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10452-3112
Country	:	US
Telephone Number	:	917-737-8555
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2021
Last Update Date	:	04/14/2021

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Directions to “ MICHELE CUPID ” Practice Location

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