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Individual

IVAN LUPTAK JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
732 HARRISON AVE, PRESTON 3RD FLOOR, BOSTON, MA 02118-2309
(617) 638-7490
Mailing address
801 ALBANY STREET, FL GROUND, BOSTON, MA 02119
(617) 414-5405
(617) 414-6031

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
237871
MA
207RC0000X
Cardiovascular Disease Physician
Primary
237871
MA

Other

Enumeration date
09/04/2008
Last updated
12/27/2019
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