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Individual

ELMER CUPINO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1695 MAIN ST FL 400, SPRINGFIELD, MA 01103-1063
(413) 241-3817
(570) 902-7736
Mailing address
4 COUNTRY LN, DOUGLASSVILLE, PA 19518-9627
(570) 617-1268
(570) 902-7736

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
72629
MA
2084P0800X
Psychiatry Physician
MD046183L
PA
2084P0804X
Child & Adolescent Psychiatry Physician
72629
MA
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD046183L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0012780540003
PA
01
02873900
CAPITAL BLUE CROSS
Enumeration date
02/17/2006
Last updated
07/03/2023
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