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General NPI Number Information
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NPI Number | 1851363055
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Entity Type | Individual
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Provider Name | JEFF D KOPELMAN
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Gender | Male
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Dates
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Enumeration Date | 02/02/2006
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Last Update Date | 03/16/2011
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Provider Practice Location Address
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Address Line | 371 MERRICK RD STE 204
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City | ROCKVILLE CTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-536-4444
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Fax | 516-536-4486
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Provider Business Mailing Address
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Address Line | 371 MERRICK RD STE 204
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City | ROCKVILLE CTRE
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State | NY
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Zip | 11570
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Country | US
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Telephone | 516-536-4444
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Fax | 516-536-4486
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | 162483
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License Number State | NY
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