MEDICARE: KATERINA KUPERMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1073062493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATERINA KUPERMAN

Provider Business Mailing Address
First Line	:	2818 W 8TH ST
Second Line	:	APT 4-J
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3359
Country	:	US
Telephone Number	:	646-641-2067
Fax Number	:

Provider Business Practice Location Address
First Line	:	3133 BRIGHTON 7TH ST
Second Line	:	APT 2-G
City	:	BROOKLYN
State	:	NY
Zip	:	11235-6565
Country	:	US
Telephone Number	:	646-641-2067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2016
Last Update Date	:	09/27/2016

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Directions to “ KATERINA KUPERMAN ” Practice Location

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