Provider Demographics
NPI:1689649980
Name:DUPLAN, AUGUSTE LYTTON (MD)
Entity Type:Individual
Prefix:DR
First Name:AUGUSTE
Middle Name:LYTTON
Last Name:DUPLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 DATES DR
Mailing Address - Street 2:CAYUGA MEDICAL CENTER AT ITHACA
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-1342
Mailing Address - Country:US
Mailing Address - Phone:607-274-4623
Mailing Address - Fax:607-274-4130
Practice Address - Street 1:101 DATES DR
Practice Address - Street 2:CAYUGA MEDICAL CENTER AT ITHACA
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-1342
Practice Address - Country:US
Practice Address - Phone:607-274-4623
Practice Address - Fax:607-274-4130
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY229792-12084P0800X
NY2297922084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02580927Medicaid
I12234Medicare UPIN
NY427BZ1Medicare ID - Type Unspecified