Individual
ATHENA ZUPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
34TH STREET & CIVIC CENTER BLVD, SUITE 9329, PHILADELPHIA, PA 19104-4399
(215) 590-1858
(215) 590-4327
Mailing address
100 EAST PENN SQUARE, THE WANAMAKER BUILDING, 9TH FLOOR, PHILADELPHIA, PA 19107-3323
(267) 425-9300
(267) 425-9331
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD065228L
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
MD065228L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018901220
—
PA
01
—
055497EMD
MEDICARE PTAN
PA
Enumeration date
08/20/2006
Last updated
04/17/2013
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