Provider Demographics
NPI:1548255789
Name:NUPP, DAVID PAUL (PT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PAUL
Last Name:NUPP
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:14 APPLETREE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2206
Mailing Address - Country:US
Mailing Address - Phone:516-579-9844
Mailing Address - Fax:
Practice Address - Street 1:4562 BELL BLVD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3355
Practice Address - Country:US
Practice Address - Phone:718-281-2861
Practice Address - Fax:718-281-0173
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY00362B-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ2959Medicare PIN
NY01846Medicare PIN