Provider Demographics
NPI:1417009895
Name:ZUPNICK, HENRY MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HENRY
Middle Name:MICHAEL
Last Name:ZUPNICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563
Mailing Address - Country:US
Mailing Address - Phone:516-593-3541
Mailing Address - Fax:516-599-8307
Practice Address - Street 1:158 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563
Practice Address - Country:US
Practice Address - Phone:516-593-3541
Practice Address - Fax:516-599-8307
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY152870207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01019832Medicaid
B20460Medicare UPIN
NY01019832Medicaid
NY7V07503931Medicare PIN