Individual
JOSHUA TZVI SCHUPP-STAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
125 SAINT PAUL ST STE 103, BURLINGTON, VT 05401-8686
(802) 216-0727
(802) 633-0956
Mailing address
125 SAINT PAUL ST STE 103, BURLINGTON, VT 05401-8462
(802) 216-0727
(802) 633-0956
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
055.0031537
VT
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
055.0031537
VT
Other
Enumeration date
03/10/2021
Last updated
03/29/2023
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