Provider Demographics
NPI:1417538109
Name:LUPICA, NOAH VINCENZO (MD)
Entity type:Individual
Prefix:DR
First Name:NOAH
Middle Name:VINCENZO
Last Name:LUPICA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:360 KINGSTOWN RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:NARRAGANSETT
Mailing Address - State:RI
Mailing Address - Zip Code:02882-3258
Mailing Address - Country:US
Mailing Address - Phone:401-789-6492
Mailing Address - Fax:
Practice Address - Street 1:360 KINGSTOWN RD UNIT 101
Practice Address - Street 2:
Practice Address - City:NARRAGANSETT
Practice Address - State:RI
Practice Address - Zip Code:02882-3258
Practice Address - Country:US
Practice Address - Phone:401-789-6492
Practice Address - Fax:401-783-9448
Is Sole Proprietor?:No
Enumeration Date:2021-04-15
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RICMD20062208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics