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General NPI Number Information
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NPI Number | 1598017881
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Entity Type | Organization
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Legal Business Name | JOEL E KOPELMAN M.D., P.A.
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 10/11/2012
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Provider Practice Location Address
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Address Line | 1200 E RIDGEWOOD AVE SUITE 1A
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3957
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Country | US
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Telephone | 201-444-4499
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Fax | 201-612-8114
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Provider Business Mailing Address
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Address Line | 1200 E RIDGEWOOD AVE SUITE 1A
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City | RIDGEWOOD
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State | NJ
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Zip | 07450-3957
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Country | US
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Telephone | 201-444-4499
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Fax | 201-612-8114
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOEL E KOPELMAN
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Credential | M.D.
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Telephone | 201-444-4499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | 25MA03556800
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License Number State | NJ
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