Kopp, John D

Kopp, John D is an individual health care provider with primary practice located at 6 Executive Park Dr , Albany NY 12203-3791. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kopp, John D can be contacted via phone (518) 482-9111.

Contact Information

Primary practice address
6 Executive Park Dr Albany NY 12203-3791
Phone: (518) 482-9111
Fax: (518) 482-6142
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 184904 New York

Profile Details

NPI number 1184696171
LBN Legal business name Kopp, John D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Feb 28th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184696171 NPPES
New York MEDICAID 01264635
New York Other 5093468
New York Other 03G682
New York Other 10001093
New York Other 04147
New York Other 0600071
New York Other 000405427004
New York Other 040426005185
New York Other 11207

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