Healthcare Provider Details

I. General information

NPI: 1699913699
Provider Name (Legal Business Name): HELEN I KOPYOFF D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HELEN I KOPYOFF DDS

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 02/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 HYLAN BLVD
STATEN ISLAND NY
10308-3360
US

IV. Provider business mailing address

1719 QUENTIN RD. APT 6C
BROOKLYN NY
11229-1219
US

V. Phone/Fax

Practice location:
  • Phone: 718-356-2700
  • Fax: 718-356-6238
Mailing address:
  • Phone: 347-426-8644
  • Fax: 347-371-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number054476
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: