Provider Demographics
NPI:1548332497
Name:KUPIN, TALYA H (MD)
Entity type:Individual
Prefix:
First Name:TALYA
Middle Name:H
Last Name:KUPIN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6298 LINTON BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-6444
Mailing Address - Country:US
Mailing Address - Phone:561-479-3884
Mailing Address - Fax:561-479-3885
Practice Address - Street 1:6298 LINTON BLVD STE 102
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-6444
Practice Address - Country:US
Practice Address - Phone:561-737-4040
Practice Address - Fax:561-369-7104
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME79238207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLF57421Medicare UPIN
FL49386Medicare ID - Type Unspecified