Provider Demographics
NPI:1669664314
Name:STUPAK, DANIEL PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:PAUL
Last Name:STUPAK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:115 TECHNOLOGY DR UNIT B106
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-6339
Mailing Address - Country:US
Mailing Address - Phone:203-452-1411
Mailing Address - Fax:203-452-1412
Practice Address - Street 1:115 TECHNOLOGY DR UNIT B106
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-6339
Practice Address - Country:US
Practice Address - Phone:203-452-1411
Practice Address - Fax:203-452-1412
Is Sole Proprietor?:No
Enumeration Date:2007-08-16
Last Update Date:2013-08-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY245703207R00000X
CT045783207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine