Dr. Jason Brett Lupow, M.D.
General Practice in Mamaroneck, NY. Individual provider (NPI-1).
NPI number1417055674
StatusActive
Last updated in NPPESOct 11, 2013
Details
- NPI
- 1417055674
- Entity type
- Individual (NPI-1)
- Name
- Dr. Jason Brett Lupow
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 20, 2006
- Last updated
- Oct 11, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | 237641 | NY | Yes |
| 207P00000X | Emergency Medicine | 25MA08061900 | NJ | |
| 207P00000X | Emergency Medicine | 237641 | NY |
Practice location
1030 W Boston Post RdMamaroneck, NY 10543-3328
Phone 914-777-2273
Mailing address
10 Mark DrRye Brook, NY 10573-1411
Phone 917-704-3356
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