Provider Demographics
NPI:1285965939
Name:ZUPICICH, SANDRA (PHD)
Entity type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:
Last Name:ZUPICICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SHOREVIEW CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PELHAM MANOR
Mailing Address - State:NY
Mailing Address - Zip Code:10803
Mailing Address - Country:US
Mailing Address - Phone:347-451-7808
Mailing Address - Fax:
Practice Address - Street 1:8 SHOREVIEW CIRCLE
Practice Address - Street 2:
Practice Address - City:PELHAM MANOR
Practice Address - State:NY
Practice Address - Zip Code:10803
Practice Address - Country:US
Practice Address - Phone:347-451-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist