Provider Demographics
NPI:1265005839
Name:STUPI, ANNEMARIE (DC)
Entity Type:Individual
Prefix:
First Name:ANNEMARIE
Middle Name:
Last Name:STUPI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-6128
Mailing Address - Country:US
Mailing Address - Phone:646-899-9876
Mailing Address - Fax:
Practice Address - Street 1:185 BROADWAY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11211-6128
Practice Address - Country:US
Practice Address - Phone:646-899-9876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-21
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR009546111N00000X
NY013456111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor