Provider Demographics
NPI:1326580259
Name:LUPA, BIANA (MPA)
Entity Type:Individual
Prefix:
First Name:BIANA
Middle Name:
Last Name:LUPA
Suffix:
Gender:F
Credentials:MPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2579 OCEAN AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4552
Mailing Address - Country:US
Mailing Address - Phone:718-307-5680
Mailing Address - Fax:718-332-3365
Practice Address - Street 1:2579 OCEAN AVE
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4552
Practice Address - Country:US
Practice Address - Phone:718-307-5680
Practice Address - Fax:718-332-3365
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-09
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator