Kupperberg, Jerald Ivan

Kupperberg, Jerald Ivan is an individual health care provider with primary practice located at 54 Howard Hill Road , Foster RI 02825. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Kupperberg, Jerald Ivan can be contacted via phone (401) 397-4638.

Contact Information

Primary practice address
54 Howard Hill Road Foster RI 02825
Phone: (401) 397-4638
Fax: (401) 397-4638
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD05404 Rhode Island

Profile Details

NPI number 1932267606
LBN Legal business name Kupperberg, Jerald Ivan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2006
Last updated Oct 4th, 2013 - about 13 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 1932267606 NPPES
Other 5352215 AETNA
Other 406111 AETNA
MEDICAID 8604 AETNA
Other 1200196 AETNA

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