Provider Demographics
NPI:1053465112
Name:LUPARELLO, PAUL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOSEPH
Last Name:LUPARELLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8000
Mailing Address - Street 2:DEPT 596
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14267-0002
Mailing Address - Country:US
Mailing Address - Phone:732-671-1697
Mailing Address - Fax:732-615-2439
Practice Address - Street 1:1270 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NJ
Practice Address - Zip Code:07748-2014
Practice Address - Country:US
Practice Address - Phone:732-615-3900
Practice Address - Fax:732-615-0865
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2011-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA59422207R00000X
NY144021207R00000X
FL0070018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ751352DE4OtherMEDICARE
NJ0091332Medicaid
NJA60694Medicare UPIN