Provider Demographics
NPI:1851553531
Name:NEAL E LUPPESCU, MD, PA
Entity Type:Organization
Organization Name:NEAL E LUPPESCU, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-595-0125
Mailing Address - Street 1:10 N GASTON AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2434
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10 N GASTON AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-2434
Practice Address - Country:US
Practice Address - Phone:908-595-0601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-25
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0443301Medicaid
NJOK4931OtherHEALTH NET
NJTS046OtherOXFORD HEALTH PLANS
NJ166274OtherAMERIHEALTH
NJ90000459600OtherAMERICHOICE
NJ0294971000OtherAMERIHEALTH
NJOK4931OtherHEALTH NET