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General NPI Number Information
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NPI Number | 1942282124
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Entity Type | Individual
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Provider Name | JUDITH GUEST COPELAND O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/15/2005
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Last Update Date | 01/20/2009
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Provider Practice Location Address
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Address Line | 204 S RIDGE ST
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City | RYE BROOK
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State | NY
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Zip | 10573-3434
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Country | US
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Telephone | 914-939-0830
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Fax | 914-939-7029
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Provider Business Mailing Address
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Address Line | 204 S RIDGE ST
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City | RYE BROOK
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State | NY
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Zip | 10573-3434
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Country | US
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Telephone | 914-939-0830
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Fax | 914-939-7029
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | VUT003706
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License Number State | NY
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