Healthcare Provider Details

I. General information

NPI: 1083528509
Provider Name (Legal Business Name): ZERQUA CHHIPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 W MERRITT BLVD
FISHKILL NY
12524-2243
US

IV. Provider business mailing address

26 W MERRITT BLVD
FISHKILL NY
12524-2243
US

V. Phone/Fax

Practice location:
  • Phone: 845-896-1310
  • Fax: 845-896-7498
Mailing address:
  • Phone: 845-896-1310
  • Fax: 845-896-7498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number273223
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: