Provider Demographics
NPI:1043322654
Name:ZLUPKO, CHRISTINE ANNETTE (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:ANNETTE
Last Name:ZLUPKO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 GRAYS WOODS BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:PORT MATILDA
Mailing Address - State:PA
Mailing Address - Zip Code:16870-7111
Mailing Address - Country:US
Mailing Address - Phone:814-272-0262
Mailing Address - Fax:814-272-1501
Practice Address - Street 1:650 GRAYS WOODS BLVD
Practice Address - Street 2:STE 120
Practice Address - City:PORT MATILDA
Practice Address - State:PA
Practice Address - Zip Code:16870-7111
Practice Address - Country:US
Practice Address - Phone:814-272-0262
Practice Address - Fax:814-272-1501
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001228152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA127135OtherHIGHMARK INDIVIDUAL ID
PA50042775OtherCAPITAL BLUE CROSS
PA1024375140001Medicaid
25126OtherHEALTH AMERICA