Provider Demographics
NPI:1023095312
Name:ZUPNICK, JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:ZUPNICK
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 1:320 HEMPSTEAD AVE
Mailing Address - Street 2:
Mailing Address - City:W. HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552
Mailing Address - Country:US
Mailing Address - Phone:516-565-2616
Mailing Address - Fax:
Practice Address - Street 1:320 HEMPSTEAD AVE
Practice Address - Street 2:
Practice Address - City:W HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11552-2043
Practice Address - Country:US
Practice Address - Phone:516-565-2616
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44851152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00851538Medicaid
NYC31211Medicare ID - Type Unspecified
NYT48981Medicare UPIN