Provider Demographics
NPI:1720174642
Name:DUPITON, MARIE-PAULE J (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIE-PAULE
Middle Name:J
Last Name:DUPITON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11706 225TH ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:CAMBRIA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11411-1706
Mailing Address - Country:US
Mailing Address - Phone:718-712-8511
Mailing Address - Fax:718-527-5624
Practice Address - Street 1:11706 225TH ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:CAMBRIA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11411-1706
Practice Address - Country:US
Practice Address - Phone:718-712-8511
Practice Address - Fax:718-527-5624
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211104208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH09413Medicare UPIN
NY561302Medicare ID - Type Unspecified