Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 138892 | NY |
N | 111NI0900X | Internist | 138892 | NY |
N | 208200000X | Surgeon | 138892 | NY |
N | 208600000X | Surgeon | 138892 | NY |
N | 2086X0206X | Surgical Oncologist | 138892 | NY |
NPI | 1386859684 |
---|---|
Provider Name | Dr. Avram M Cooperman |
First Address | Dobbs Ferry, NY 10522-0207 |
Second Address | New York, NY 10003-2602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B09986 | (02) | NY |