Provider Demographics
NPI:1467446351
Name:DAVID NUPP, P.T., P.C.
Entity Type:Organization
Organization Name:DAVID NUPP, P.T., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:NUPP
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:516-728-1106
Mailing Address - Street 1:14 APPLETREE LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756-2206
Mailing Address - Country:US
Mailing Address - Phone:516-728-1106
Mailing Address - Fax:
Practice Address - Street 1:14 APPLETREE LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-2206
Practice Address - Country:US
Practice Address - Phone:516-728-1106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0036281261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01846Medicare PIN
NYQ29592Medicare PIN