1659340859 NPI number — DR. RICHARD S KOPLIN M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659340859 NPI number — DR. RICHARD S KOPLIN M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

KOPLIN

Provider First Name:

RICHARD

Provider Middle Name:

S

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

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:

1659340859

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

09/12/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

310 E 14TH ST

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

NEW YORK

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

10003-4201

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

212-505-6550

Provider Business Mailing Address Fax Number:

212-979-1772

Provider First Line Business Practice Location Address:

310 E 14TH ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

NEW YORK

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

10003-4201

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

212-505-6550

Provider Business Practice Location Address Fax Number:

212-979-1772

Provider Enumeration Date:

03/17/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207W00000X , with the licence number:  106488 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 1C2534 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 181922032 . This is a "PALMETTO ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 313619 . This is a "UNITED HC ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 96309 . This is a "AETNA ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 0055800 . This is a "GHI ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 106488B40 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 169940 . This is a "ELDERPLAN ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 51414 . This is a "VYTRA ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: M6755P . This is a "HIP ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 00186934 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 539161 . This is a "BCBS ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: NS411 . This is a "OXFORD ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".