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General NPI Number Information
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NPI Number | 1114511409
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Entity Type | Organization
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Legal Business Name | LAURA POPPER, MD. PC
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Dates
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Enumeration Date | 02/26/2021
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 116 EAST 66TH STREET #1C
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City | NEW YORK CITY
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State | NY
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Zip | 10065
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Country | US
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Telephone | 212-794-2136
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Fax | 212-734-0855
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Provider Business Mailing Address
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Address Line | 116 EAST 66TH STREET #1C
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City | NEW YORK CITY
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State | NY
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Zip | 10065
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Country | US
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Telephone | 212-794-2136
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Fax | 212-734-0855
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. KATHLEEN EILLORE HARRIS
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Credential | AM
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Telephone | 212-794-2136
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number |
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License Number State |
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