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NPI Code Detail

MEDICARE: LISA D COPLIT MD

MEDICARE: LISA D COPLIT MD
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
1207R00000XInternal Medicine Physician220922NY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1006AS06491OTHERNYMEDICARE

General Provider Information

NPI Number : 1194756791
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA D COPLIT MD
Provider Business Mailing Address
First Line : 275 MOUNT CARMEL AVE
Second Line :
City : HAMDEN
State : CT
Zip : 06518-1961
Country : US
Telephone Number : 203-582-6493
Fax Number :
Provider Business Practice Location Address
First Line : 2800 MAIN ST
Second Line :
City : BRIDGEPORT
State : CT
Zip : 06606-4201
Country : US
Telephone Number : 475-210-5440
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 02/18/2020

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