Provider Demographics
NPI:1124361670
Name:LUPI, ERICA A (NP)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:LUPI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 MALL RD
Mailing Address - Street 2:LAHEY CLINIC, INC.
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01805-0001
Mailing Address - Country:US
Mailing Address - Phone:978-388-5050
Mailing Address - Fax:978-388-4035
Practice Address - Street 1:24 MORRILL PL
Practice Address - Street 2:LAHEY AMESBURY
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913-3530
Practice Address - Country:US
Practice Address - Phone:978-388-5050
Practice Address - Fax:978-388-4035
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MARN285322363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110095786AMedicaid
MA003202201Medicare PIN