Provider Demographics
NPI:1699272674
Name:ZUPSIC EYE ASSOCIATES LLC
Entity type:Organization
Organization Name:ZUPSIC EYE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:E
Authorized Official - Last Name:ZUPSIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-744-2136
Mailing Address - Street 1:211 CATTAIL LN
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-1892
Mailing Address - Country:US
Mailing Address - Phone:609-744-2136
Mailing Address - Fax:
Practice Address - Street 1:802 DELSEA DR N
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-1438
Practice Address - Country:US
Practice Address - Phone:856-582-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-06
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00549101152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty