Basic Information
| Provider Information | |||||||||
| NPI: | 1780143057 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LUPEZ | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | LUPTON | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 DARTMOUTH ST APT 1 | ||||||||
| Address2: | |||||||||
| City: | BOSTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021165999 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9196412199 | ||||||||
| FaxNumber: | 6174149251 | ||||||||
| Practice Location | |||||||||
| Address1: | 163 GORE ST | ||||||||
| Address2: | |||||||||
| City: | CAMBRIDGE | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021411119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6176653000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/17/2019 | ||||||||
| LastUpdateDate: | 06/08/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/08/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 279520 | MA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207R00000X | 291749 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.