Provider Demographics
NPI:1144868282
Name:CHUPP, SYLVANUS AUGUSTUS (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SYLVANUS
Middle Name:AUGUSTUS
Last Name:CHUPP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3258 BRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-3459
Mailing Address - Country:US
Mailing Address - Phone:732-892-5673
Mailing Address - Fax:
Practice Address - Street 1:3258 BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-3459
Practice Address - Country:US
Practice Address - Phone:732-892-5673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-19
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI04043000183500000X
NY065904183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist