Provider Demographics
NPI:1548296643
Name:LUPPESCU, NEAL E (MD)
Entity type:Individual
Prefix:DR
First Name:NEAL
Middle Name:E
Last Name:LUPPESCU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 N GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2434
Mailing Address - Country:US
Mailing Address - Phone:908-595-0601
Mailing Address - Fax:908-595-0604
Practice Address - Street 1:10 N GASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2434
Practice Address - Country:US
Practice Address - Phone:908-595-0601
Practice Address - Fax:908-595-0604
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA51454174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0443301Medicaid
NJOK4931OtherHEALTH NET
NJTS046OtherOXFORD HEALTH PLANS
NJ223486144OtherHORIZON BLUE CROSS BLUE SHIED OF NEW JERSEY
NJOK4931OtherHEALTH NET
NJ0443301Medicaid