Provider Demographics
NPI:1699987909
Name:ZUPA, VICKIE (VICTORIA) (ND, FNCFM)
Entity type:Individual
Prefix:DR
First Name:VICKIE (VICTORIA)
Middle Name:
Last Name:ZUPA
Suffix:
Gender:F
Credentials:ND, FNCFM
Other - Prefix:
Other - First Name:VICKIE
Other - Middle Name:
Other - Last Name:ZUPA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 363
Mailing Address - Street 2:
Mailing Address - City:NEW CANAAN
Mailing Address - State:CT
Mailing Address - Zip Code:06840-0363
Mailing Address - Country:US
Mailing Address - Phone:203-972-0402
Mailing Address - Fax:203-972-0410
Practice Address - Street 1:49 LOCUST AVE STE 101
Practice Address - Street 2:
Practice Address - City:NEW CANAAN
Practice Address - State:CT
Practice Address - Zip Code:06840-4764
Practice Address - Country:US
Practice Address - Phone:203-972-0402
Practice Address - Fax:203-972-0410
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ95-459175F00000X
NH104175F00000X
CT000138175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath