MEDICARE: DR. MARTIN DAVID LUPOWITZ D.C.

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	111N00000X	Chiropractor	X006669	NY

General Provider Information

NPI Number	:	1306829262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARTIN DAVID LUPOWITZ D.C.

Provider Business Mailing Address
First Line	:	13 SUOMINEN LN
Second Line	:
City	:	ULSTER PARK
State	:	NY
Zip	:	12487-5343
Country	:	US
Telephone Number	:	845-626-2500
Fax Number	:	888-972-4614

Provider Business Practice Location Address
First Line	:	2919 LUCAS TPKE
Second Line	:
City	:	ACCORD
State	:	NY
Zip	:	12404-5633
Country	:	US
Telephone Number	:	845-626-2500
Fax Number	:	888-972-4614

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

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	05/01/2023

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