Provider Demographics
NPI:1831505643
Name:ROBERT C CUPELO MD PLLC
Entity type:Organization
Organization Name:ROBERT C CUPELO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:CUPELO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-218-0430
Mailing Address - Street 1:5000 BRITTONFIELD PKWY
Mailing Address - Street 2:SUITE A124
Mailing Address - City:EAST SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13057-9226
Mailing Address - Country:US
Mailing Address - Phone:315-446-3904
Mailing Address - Fax:315-552-6590
Practice Address - Street 1:5000 BRITTONFIELD PKWY
Practice Address - Street 2:SUITE A124
Practice Address - City:EAST SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13057-9226
Practice Address - Country:US
Practice Address - Phone:315-218-0430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty