MEDICARE: RE-PARTNERS-LONG ISLAND, LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VE0102X	Reproductive Endocrinology Physician

General Provider Information

NPI Number	:	1083861462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RE-PARTNERS-LONG ISLAND, LLP

Provider Business Mailing Address
First Line	:	400 GARDEN CITY PLZ
Second Line	:	SUITE 107
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-3322
Country	:	US
Telephone Number	:	516-746-3633
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 GARDEN CITY PLZ
Second Line	:	SUITE 107
City	:	GARDEN CITY
State	:	NY
Zip	:	11530-3322
Country	:	US
Telephone Number	:	516-746-3633
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	ALAN COPPERMAN
Credential	:	M.D
Telephone Number	:	212-756-5777

Provider Enumeration Date	:	08/27/2008
Last Update Date	:	08/27/2008

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