Healthcare Provider Details

I. General information

NPI: 1689962474
Provider Name (Legal Business Name): CATHERINE ANN POPADIUK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2011
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 ATLANTIC AVE
BROOKLYN NY
11217-5229
US

IV. Provider business mailing address

395 ATLANTIC AVE
BROOKLYN NY
11217-5229
US

V. Phone/Fax

Practice location:
  • Phone: 718-392-1910
  • Fax:
Mailing address:
  • Phone: 718-392-1910
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number329938
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License NumberH0093093
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberH0093093
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: