Organization
HERITAGE EYECARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANALICIA NICOLE CZUPRYK OD (OPTOMETRIST/MANAGER)
(503) 701-2557
Entity
Organization
Contact information
Practice address
2169 14TH AVE SE, ALBANY, OR 97322-8510
(541) 926-2061
(541) 926-4845
Mailing address
2169 14TH AVE SE, ALBANY, OR 97322-8510
(541) 926-2061
(541) 926-4845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3445ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710248638
INDIVIDUAL NPI
OR
Enumeration date
05/29/2014
Last updated
07/10/2014
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