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General NPI Number Information
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NPI Number | 1033386206
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Entity Type | Organization
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Legal Business Name | BRYAN G. POPOVICI, DPM, PC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 7304 OSWEGO RD
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City | LIVERPOOL
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State | NY
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Zip | 13090-3718
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Country | US
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Telephone | 315-451-8256
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Fax | 315-451-2335
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Provider Business Mailing Address
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Address Line | 7304 OSWEGO ROAD
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City | LIVERPOOL
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State | N.Y.
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Zip | 13090
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Country | UM
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Telephone | 315-451-8256
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Fax | 315-451-2335
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Authorized Official
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Title or Position | PODIATRIST
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Name | BRYAN G. POPOVICI
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Credential | DPM
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Telephone | 315-451-8256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | NOO3830
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License Number State | NY
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