Provider Demographics
NPI:1750412722
Name:PARUPSKY, GERALD (OD)
Entity type:Individual
Prefix:
First Name:GERALD
Middle Name:
Last Name:PARUPSKY
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 1:1801 WARD AVE
Mailing Address - Street 2:SUITE 264 PLAZA94
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-2119
Mailing Address - Country:US
Mailing Address - Phone:715-386-8401
Mailing Address - Fax:715-386-8476
Practice Address - Street 1:1801 WARD AVE
Practice Address - Street 2:SUITE 264 PLAZA94
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-2119
Practice Address - Country:US
Practice Address - Phone:715-386-8401
Practice Address - Fax:715-386-8476
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1250-035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI47212Medicare UPIN