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General NPI Number Information
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NPI Number | 1912310673
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Entity Type | Individual
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Provider Name | KRISTIN STUPIANSKY O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 1919 PENNSYLVANIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20006-3404
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Country | US
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Telephone | 202-467-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 800 NEW JERSEY AVE SE APT 932
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City | WASHINGTON
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State | DC
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Zip | 20003-3999
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Country | US
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Telephone | 303-817-2286
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | TA2609
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618002604
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OP1000368
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License Number State | DC
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