Healthcare Provider Details

I. General information

NPI: 1881741163
Provider Name (Legal Business Name): CLAUDIA LYNN KOPPELMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 12/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 MAIN ST SUITE 205
HOLYOKE MA
01040-5396
US

IV. Provider business mailing address

1221 MAIN ST SUITE 205
HOLYOKE MA
01040-5396
US

V. Phone/Fax

Practice location:
  • Phone: 413-533-1818
  • Fax: 413-532-4668
Mailing address:
  • Phone: 413-533-1818
  • Fax: 413-532-4668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number56227
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: