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General NPI Number Information
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NPI Number | 1700074374
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Entity Type | Organization
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Legal Business Name | MICHAEL COOPERMAN
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 380 2ND AVE 301
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City | NEW YORK
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State | NY
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Zip | 10010-5615
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Country | US
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Telephone | 212-777-2527
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Fax | 917-591-2660
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Provider Business Mailing Address
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Address Line | 380 2ND AVE 301
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City | NEW YORK
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State | NY
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Zip | 10010-5615
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Country | US
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Telephone | 212-777-2527
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Fax | 917-591-2660
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MICHAEL COOPERMAN
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Credential |
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Telephone | 212-777-2527
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 003858
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License Number State | NY
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