Provider Demographics
NPI:1275776981
Name:KUPRIYEVA, ANNA (DPM, MPH)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:KUPRIYEVA
Suffix:
Gender:F
Credentials:DPM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 CENTRAL AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-4046
Mailing Address - Country:US
Mailing Address - Phone:518-869-5799
Mailing Address - Fax:518-862-1489
Practice Address - Street 1:1692 CENTRAL AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-4046
Practice Address - Country:US
Practice Address - Phone:518-869-5799
Practice Address - Fax:518-862-1489
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY006548213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery