Provider Demographics
NPI:1841220829
Name:LUPYAN, YAN (MD)
Entity Type:Individual
Prefix:
First Name:YAN
Middle Name:
Last Name:LUPYAN
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 1:6 CORNWALL COURT
Mailing Address - Street 2:SUITE E
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816
Mailing Address - Country:US
Mailing Address - Phone:732-257-0003
Mailing Address - Fax:732-651-8023
Practice Address - Street 1:6 CORNWALL COURT
Practice Address - Street 2:SUITE E
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816
Practice Address - Country:US
Practice Address - Phone:732-257-0003
Practice Address - Fax:732-651-8023
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ637732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF99595Medicare UPIN