Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MA43494 | NJ |
N | 208600000X | Surgeon | MA43494 | NJ |
Y | 2086S0129X | Vascular Surgeon | MA43494 | NJ |
NPI | 1114086527 |
---|---|
Provider Name | Kevin Lopyan |
First Address | Eatontown, NJ 07724 |
Second Address | Eatontown, NJ 07724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2006 |
Last Update Date | 14/11/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
5372500 | (05) | NJ |
E96693 | (02) |