Individual
DR. EHAB ELIAS TUPPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1083 GOFFLE RD, HAWTHORNE, NJ 07506-2013
(973) 427-2421
(973) 427-6205
Mailing address
1083 GOFFLE RD, HAWTHORNE, NJ 07506-2013
(973) 427-2421
(973) 427-6205
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB06525200
NJ
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
25MB06525200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0007412
—
NJ
Enumeration date
07/18/2005
Last updated
12/17/2021
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