1275575409 NPI number — VALERIE POPKIN M.D.

Table of content: VALERIE POPKIN M.D. (NPI 1275575409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275575409 NPI number — VALERIE POPKIN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
POPKIN
Provider First Name:
VALERIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275575409
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
196 PARKWAY SOUTH
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
WATERFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06385
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-443-4383
Provider Business Mailing Address Fax Number:
860-443-3980

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
196 PARKWAY S
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
WATERFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06385-1234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-443-4383
Provider Business Practice Location Address Fax Number:
860-443-3980
Provider Enumeration Date:
06/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  38610 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 06-1616101 . This is a "COMM. HEALTH NETWORK/ECCD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 06-1616101 . This is a "UNITHEDHEALTHCARE/ECCD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0V7346 . This is a "HEALTHNET/ECCG:06-1049086" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010038610CT01 . This is a "ANTHEM/ECCG:06-1049086" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500HBC444CT01 . This is a "ANTHEM/HOSP-BASED ECCD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2069799 . This is a "OXFORD/ECCG: 06-1049086" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2524335 . This is a "OXFORD/ECCD: 06-1616101" identifier . This identifiers is of the category "OTHER".
  • Identifier: 06-1049086 . This is a "COMM HEALTH NETWORK/ECCG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 06-1049086 . This is a "UNITEDHEALTHCARE/ECCG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060059639 . This is a "RR MED/ECCG:06-1049086" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001386102 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 038610 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060064818 . This is a "RR MED/ECCD:06-1616101" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010038610CT04 . This is a "ANTHEM/ECCD: 06-1616101" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001002815 . This is a "BLUECARE FAMILY PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0V9739 . This is a "HEALTHNET/ECCD:06-1616101" identifier . This identifiers is of the category "OTHER".




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