MEDICARE: DR. NATASHA L COPELIN DNP

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	363LA2200X	Adult Health Nurse Practitioner	308729	NY

General Provider Information

NPI Number	:	1699104042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NATASHA L COPELIN DNP

Provider Business Mailing Address
First Line	:	13 MOHAWK DR
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3303
Country	:	US
Telephone Number	:	631-486-8566
Fax Number	:	631-607-8933

Provider Business Practice Location Address
First Line	:	13 MOHAWK DR
Second Line	:
City	:	NORTH BABYLON
State	:	NY
Zip	:	11703-3303
Country	:	US
Telephone Number	:	631-486-8566
Fax Number	:	631-607-8933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2013
Last Update Date	:	09/25/2024

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