Provider Demographics
NPI:1639538598
Name:TUPI, YLLKA
Entity Type:Individual
Prefix:
First Name:YLLKA
Middle Name:
Last Name:TUPI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 GATES AVE APT 2L
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11385-3030
Mailing Address - Country:US
Mailing Address - Phone:347-258-0513
Mailing Address - Fax:
Practice Address - Street 1:2055 GATES AVE APT 2L
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-3030
Practice Address - Country:US
Practice Address - Phone:347-258-0513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-19
Last Update Date:2016-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist