Provider Demographics
NPI:1619060951
Name:CIOPYK, ZENON (OD)
Entity Type:Individual
Prefix:DR
First Name:ZENON
Middle Name:
Last Name:CIOPYK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 LAKES CORNERS ROSE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:NY
Mailing Address - Zip Code:14433-9724
Mailing Address - Country:US
Mailing Address - Phone:315-587-4092
Mailing Address - Fax:
Practice Address - Street 1:117 E UNION ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NY
Practice Address - Zip Code:14513-1503
Practice Address - Country:US
Practice Address - Phone:315-331-7917
Practice Address - Fax:315-331-7917
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY4269152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00852800Medicaid
NY101958CSOtherPREFERRED CARE
NYT49093Medicare UPIN