Individual
NICOLE LUPO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
255 MONMOUTH RD, OAKHURST, NJ 07755-1515
(732) 531-5445
Mailing address
10 CRIMSON LN, FREEHOLD, NJ 07728-9013
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MP00434000
NJ
Other
Enumeration date
06/21/2017
Last updated
06/21/2017
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