Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 25MB09221700 | NJ |
Y | 207RH0002X | Hospice and Palliative Medicine | 25MB09221700 | NJ |
NPI | 1760716575 |
---|---|
Provider Name | Lori Helene Kopperman |
First Address | Boston, MA 02241-6457 |
Second Address | Morristown, NJ 07960-6136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2009 |
Last Update Date | 31/05/2017 |