Provider Demographics
NPI:1568592954
Name:ZUPA, VICTORIA L (OD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:L
Last Name:ZUPA
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 1:502 STONEWALL CT
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2947
Mailing Address - Country:US
Mailing Address - Phone:201-694-7701
Mailing Address - Fax:
Practice Address - Street 1:150 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4311
Practice Address - Country:US
Practice Address - Phone:201-694-7701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYNY5512152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist