Individual
PRUDENCIO CUPAT SY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
BLDG 159 NAVSUBASE NLON, NAVAL UNDERSEA MEDICAL INSTITUTE, GROTON, CT 06349-5159
(860) 694-2876
Mailing address
BLDG 159 NAVSUBASE NLON, NAVAL UNDERSEA MEDICAL INSTITUTE, GROTON, CT 06349-5159
(860) 694-2876
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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