Provider Demographics
NPI:1528195930
Name:CUPELLI, ALFRED A (DR)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:A
Last Name:CUPELLI
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DRAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241
Mailing Address - Country:US
Mailing Address - Phone:412-831-3373
Mailing Address - Fax:412-831-3777
Practice Address - Street 1:5750 CENTRE AVENUE
Practice Address - Street 2:SUITE 310
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-661-8255
Practice Address - Fax:412-661-8229
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS022861L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA433667OtherUNITED CONCORDIA