Healthcare Provider Details

I. General information

NPI: 1861068967
Provider Name (Legal Business Name): MR. DAVID WELDON POPOK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2021
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CEDAR ST
NEW ROCHELLE NY
10801-5247
US

IV. Provider business mailing address

20 CEDAR ST
NEW ROCHELLE NY
10801-5247
US

V. Phone/Fax

Practice location:
  • Phone: 914-534-5103
  • Fax: 914-534-5198
Mailing address:
  • Phone: 914-534-5103
  • Fax: 914-534-5198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number338226
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: