Provider Demographics
NPI:1124140074
Name:TUPUE, ALLEN RENE ARCILLA (PT)
Entity type:Individual
Prefix:MR
First Name:ALLEN RENE
Middle Name:ARCILLA
Last Name:TUPUE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 TUERS AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3268
Mailing Address - Country:US
Mailing Address - Phone:201-736-2822
Mailing Address - Fax:
Practice Address - Street 1:626 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071-3206
Practice Address - Country:US
Practice Address - Phone:201-372-3240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPT40QA01078900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist