Provider Demographics
NPI:1932672805
Name:YUPA, MARIA G
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name:YUPA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 AVENUE OF AMERICAS
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9904
Mailing Address - Country:US
Mailing Address - Phone:212-633-9300
Mailing Address - Fax:
Practice Address - Street 1:119 TOMPKINS AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10304-2601
Practice Address - Country:US
Practice Address - Phone:917-485-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker