Provider Demographics
NPI:1285457325
Name:TUPICK, ANGELA VALERIE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:VALERIE
Last Name:TUPICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HEMLOCK LN APT 1
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-3069
Mailing Address - Country:US
Mailing Address - Phone:603-723-6082
Mailing Address - Fax:
Practice Address - Street 1:17 HEMLOCK LN APT 1
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3069
Practice Address - Country:US
Practice Address - Phone:603-723-6082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-06
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NHI0307253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care