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General NPI Number Information
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NPI Number | 1699272674
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Entity Type | Organization
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Legal Business Name | ZUPSIC EYE ASSOCIATES LLC
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Dates
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Enumeration Date | 04/06/2018
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Last Update Date | 09/15/2018
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Provider Practice Location Address
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Address Line | 802 DELSEA DR N
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City | GLASSBORO
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State | NJ
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Zip | 08028-1438
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Country | US
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Telephone | 856-582-5550
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Fax |
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Provider Business Mailing Address
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Address Line | 211 CATTAIL LN
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City | MULLICA HILL
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State | NJ
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Zip | 08062-1892
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Country | US
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Telephone | 609-744-2136
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER E ZUPSIC
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Credential |
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Telephone | 609-744-2136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00549101
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License Number State | NJ
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