Provider Demographics
NPI:1710419031
Name:LUPERO INC
Entity Type:Organization
Organization Name:LUPERO INC
Other - Org Name:LICE CLINICS OF AMERICA - PHILADELPHIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZUTO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-514-1903
Mailing Address - Street 1:1982 BUTLER PIKE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:CONSHOHOCKEN
Mailing Address - State:PA
Mailing Address - Zip Code:19428-3701
Mailing Address - Country:US
Mailing Address - Phone:610-222-6149
Mailing Address - Fax:
Practice Address - Street 1:1982 BUTLER PIKE
Practice Address - Street 2:SUITE 4
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-3701
Practice Address - Country:US
Practice Address - Phone:610-222-6149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty