Provider Demographics
NPI:1568416105
Name:MICHAEL F LUPINACCI MD PC
Entity Type:Organization
Organization Name:MICHAEL F LUPINACCI MD PC
Other - Org Name:PRISM CENTER FOR SPINE & PAIN CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
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 STE 106
Mailing Address - Street 2:PRISM
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17109-5333
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 100
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17109-5300
Practice Address - Country:US
Practice Address - Phone:717-703-3920
Practice Address - Fax:717-703-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA250004857OtherRAILROAD MEDICARE
PA102272Medicare PIN