1619021839 NPI number — DR. NEIL J KOPPEL D.C., L.AC.

Table of content: DR. NEIL J KOPPEL D.C., L.AC. (NPI 1619021839)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619021839 NPI number — DR. NEIL J KOPPEL D.C., L.AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOPPEL
Provider First Name:
NEIL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C., L.AC.
Provider Gender Code:
M

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:
1619021839
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1213 PIPER BLVD STE 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NAPLES
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34110-1393
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
239-214-0214
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1213 PIPER BLVD STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NAPLES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34110-1393
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
239-214-0214
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/23/2007

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: 111N00000X , with the licence number:  X008178-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171100000X , with the licence number: 002077-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111N00000X , with the licence number: CH 8701 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: X008178-1 . This is a "CHIROPRACTIC LICENSE #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 002077-1 . This is a "ACUPUNCTURE LICENSE #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: C08178-8 . This is a "WORKERS COMPENSATION #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5804163 . This is a "GHI PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1897046 . This is a "OXFORD PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: X1C921 . This is a "EMPIRE BCBS PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CH 8701 . This is a "CHIROPRACTIC LICENSE #" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".