Lisa M Pupa PHD LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35SI00351200 Issued in NJ

Legal business name

LISA M PUPA PHD LLC

Practice address

2164 Highway 35 BLDG B
Sea Girt, NJ 08750-1013

Phone

(732) 359-7675

Fax

(732) 359-7674

NPI assigned

Sep 3, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lisa M Pupa-O'Sullivan, PHDNPI 1932156320

Title

Owner Operator

Phone

(732) 359-7675

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lisa M Pupa-O'Sullivan, PHD

  • Clinical Psychologist
  • Sea Girt, NJ
  • NPI 1932156320
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1992012405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2164 HIGHWAY 35 BLDG B",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501013",
            "telephone_number": "732-359-7675",
            "fax_number": "732-359-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2164 HIGHWAY 35 BLDG B",
            "city": "SEA GIRT",
            "state": "NJ",
            "postal_code": "087501013",
            "telephone_number": "732-359-7675",
            "fax_number": "732-359-7674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA M PUPA PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-03",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "PUPA-O'SULLIVAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "732-359-7675",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NJ",
            "license": "35SI00351200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "P00667132",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Teresa Larkin, LCSW
• William Librizzi, PSYD
• Danielle Elyse Lichtenfeld, L.AC
• Amy Lin, DDS
• Ying Lin, M.D.
• John L Little, DDS
• John P Little, DMD
• Zilie Roselyn Louis
• Mary B Lutz, M.D.
• Mager Enterprises Inc.

• Clinical Psychologist in Sea Girt, NJ
• Providers in Sea Girt, NJ by specialty
• Clinical Psychologist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.