# JOSHUA TZVI SCHUPP-STAR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1376128447
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 055.0031537 | VT | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 055.0031537 | VT | Yes |

## Other

- **Enumeration date:** 03/10/2021
- **Last updated:** 03/29/2023