Individual
MARTIN JOSEPH LUPO
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
141 MARK TREE RD, CENTEREACH, NY 11720-2221
(631) 467-4235
(631) 467-2655
Mailing address
9 WALNUT ST, CENTEREACH, NY 11720-1725
(631) 467-4235
(631) 467-2655
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006327-1
NY
Other
Enumeration date
01/20/2006
Last updated
07/08/2007
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