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General NPI Number Information
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NPI Number | 1972544971
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Entity Type | Individual
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Provider Name | JEFFREY EVAN GROPPER DO
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Gender | Male
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 MONTAUK HIGHWAY
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City | WEST ISLIP
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State | NY
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Zip | 11795
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Country | US
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Telephone | 631-376-4088
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Fax |
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Provider Business Mailing Address
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Address Line | 3 BOYLE ROAD
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City | SELDEN
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State | NY
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Zip | 11784
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Country | US
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Telephone | 631-736-4064
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Fax | 631-736-1332
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 1849111
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License Number State | NY
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