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NPI Code Detail

MEDICARE: DR. IRIS H KOPELOFF M.D.

MEDICARE: DR. IRIS H KOPELOFF M.D.
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
1207N00000XDermatology PhysicianMA59835NJ

General Provider Information

NPI Number : 1518934058
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. IRIS H KOPELOFF M.D.
Provider Business Mailing Address
First Line : 1200 E RIDGEWOOD AVE
Second Line : SUITE 107
City : RIDGEWOOD
State : NJ
Zip : 07450-3957
Country : US
Telephone Number : 201-689-2103
Fax Number : 201-689-2108
Provider Business Practice Location Address
First Line : 1200 E RIDGEWOOD AVE
Second Line : SUITE 107
City : RIDGEWOOD
State : NJ
Zip : 07450-3957
Country : US
Telephone Number : 201-689-2103
Fax Number : 201-689-2108
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2006
Last Update Date : 09/18/2014

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Directions to “ DR. IRIS H KOPELOFF M.D.” Practice Location

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