MEDICARE: DR. CHRISTINE ANNETTE ZLUPKO O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OEG001228	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	127135	OTHER	PA	HIGHMARK INDIVIDUAL ID
2	50042775	OTHER	PA	CAPITAL BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	25126	OTHER		HEALTH AMERICA

General Provider Information

NPI Number	:	1043322654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINE ANNETTE ZLUPKO O.D.

Provider Business Mailing Address
First Line	:	650 GRAYS WOODS BLVD
Second Line	:	STE 120
City	:	PORT MATILDA
State	:	PA
Zip	:	16870-7111
Country	:	US
Telephone Number	:	814-272-0262
Fax Number	:	814-272-1501

Provider Business Practice Location Address
First Line	:	650 GRAYS WOODS BLVD
Second Line	:	STE 120
City	:	PORT MATILDA
State	:	PA
Zip	:	16870-7111
Country	:	US
Telephone Number	:	814-272-0262
Fax Number	:	814-272-1501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	04/02/2020

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