Individual
DR. JASON BRETT LUPOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1030 W BOSTON POST RD, MAMARONECK, NY 10543-3328
(914) 777-2273
Mailing address
10 MARK DR, RYE BROOK, NY 10573-1411
(917) 704-3356
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
237641
NY
207P00000X
Emergency Medicine Physician
25MA08061900
NJ
208D00000X
General Practice Physician
Primary
237641
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00391144
RAILROAD
NJ
Enumeration date
09/20/2006
Last updated
10/11/2013
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