Individual
ROBERT JOHN KUPIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
196 PARKWAY SOUTH, SUITE 103, WATERFORD, CT 06385
(860) 443-4383
(860) 443-3980
Mailing address
196 PARKWAY SOUTH, SUITE 103, WATERFORD, CT 06385
(860) 443-4383
(860) 443-3980
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
893
CT
363A00000X
Physician Assistant
Primary
58266
CA
363AM0700X
Medical Physician Assistant
000893
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004210407
BLUECARE FAMILY PLAN
—
01
—
06-1049086
COMMUNITY HEALTH NETWORK
—
01
—
06-1616101
COMMUNITY HEALTH NETWORK
—
01
—
060064824
RR MED/ECCD: 06-1616101
—
01
—
0V9726
HEALTHNET/ECCG:06-1049086
—
01
—
0V9727
HEALTHNET/ECCD:06-1616101
—
01
—
290000893CT01
ANTHEM/ECCG:06-1049086
—
01
—
290001019CT03
ANTHEM/ECCD:06-1616101
—
01
—
500HBC444CT01
ANTHEM/HOSP-BASED ECCD
—
01
—
641664
CONNECTICARE
—
01
—
970011351
RR MED/ECCG: 06-1049086
—
01
—
P2626854
OXFORD/ECCD: 06-1616101
—
01
—
P2650601
OXFORD/ECCG: 06-1049086
—
Enumeration date
06/12/2006
Last updated
02/16/2024
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