Healthcare Provider Details

I. General information

NPI: 1992815989
Provider Name (Legal Business Name): JULIE ELIZABETH EHRMAN KUPERSMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 QUAKER RIDGE RD
NEW ROCHELLE NY
10804-2808
US

IV. Provider business mailing address

77 QUAKER RIDGE RD
NEW ROCHELLE NY
10804-2808
US

V. Phone/Fax

Practice location:
  • Phone: 914-235-5171
  • Fax: 914-235-5174
Mailing address:
  • Phone: 914-235-5171
  • Fax: 914-235-5174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number223202
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: