Provider Demographics
NPI:1518220086
Name:MICHAEL F LUPINACCI MD, PC
Entity Type:Organization
Organization Name:MICHAEL F LUPINACCI MD, PC
Other - Org Name:PHYSICIANS OF REHABILITATION, INDUSTRIAL & SPINE MEDICINE, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FRANK
Authorized Official - Last Name:LUPINACCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-691-3755
Mailing Address - Street 1:4310 LONDONDERRY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5300
Mailing Address - Country:US
Mailing Address - Phone:717-561-4242
Mailing Address - Fax:717-561-4903
Practice Address - Street 1:4310 LONDONDERRY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5300
Practice Address - Country:US
Practice Address - Phone:717-561-4242
Practice Address - Fax:717-561-4903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-20
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012483400005Medicaid
PA0012483400005Medicaid