Provider Demographics
NPI:1811694888
Name:LUPO, FRANCIS (PT,DPT)
Entity type:Individual
Prefix:
First Name:FRANCIS
Middle Name:
Last Name:LUPO
Suffix:
Gender:M
Credentials:PT,DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 SAVO LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-2742
Mailing Address - Country:US
Mailing Address - Phone:347-782-1011
Mailing Address - Fax:
Practice Address - Street 1:1243 WOODROW RD STE 323
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-1725
Practice Address - Country:US
Practice Address - Phone:718-966-0111
Practice Address - Fax:718-966-0087
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY050081225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist