Provider Demographics
NPI:1568641827
Name:LUPSKI, ROBERT S (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:S
Last Name:LUPSKI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2611
Mailing Address - Country:US
Mailing Address - Phone:631-880-8354
Mailing Address - Fax:
Practice Address - Street 1:403 WILLIAM FLOYD PKWY
Practice Address - Street 2:
Practice Address - City:SHIRLEY
Practice Address - State:NY
Practice Address - Zip Code:11967-3473
Practice Address - Country:US
Practice Address - Phone:631-399-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY038837183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist