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Individual
SAMUEL LUPIN
Active
Individual
SAMUEL LUPIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
138014
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035751
GHI
NY
05
—
00799555
—
NY
01
—
31A671
BLUE CROSS BLUE SHIELD
NY
01
—
NZ8794
HEALTHNET
NY
01
—
P770149
OXFORD
NY
Enumeration date
06/12/2007
Last updated
05/25/2010
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