Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207KA0200X | Allergist | 206064 | NY |
NPI | 1316936339 |
---|---|
Provider Name | Dr. Terese Agnes Copeland |
First Address | Saratoga Springs, NY 12866-5555 |
Second Address | Saratoga Springs, NY 12866 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 25/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01760076 | (05) | NY |
F75657 | (02) |