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General NPI Number Information
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NPI Number | 1992717540
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Entity Type | Individual
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Provider Name | LAURIE KOPIN NP
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Gender | Female
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 07/05/2023
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Provider Practice Location Address
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Address Line | 2400 S CLINTON AVE BUILDING G - CARDIOLOGY
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City | ROCHESTER
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State | NY
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Zip | 14618-2668
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Country | US
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Telephone | 585-341-7700
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Fax | 585-341-4213
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Provider Business Mailing Address
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Address Line | 601 ELMWOOD AVE BOX 679B
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City | ROCHESTER
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State | NY
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Zip | 14642-0001
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Country | US
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Telephone | 585-275-2475
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Fax | 585-473-0477
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 287236-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 301154
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License Number State | NY
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