Koppel, Carolyn

Koppel, Carolyn is an individual health care provider with primary practice located at 1301 Trumansburg Rd Suite H, Ithaca NY 14850-1397. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Koppel, Carolyn can be contacted via phone (607) 272-6880.

Contact Information

Primary practice address
1301 Trumansburg Rd Suite H Ithaca NY 14850-1397
Fax: (607) 272-1436
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X F381159-1 New York

Profile Details

NPI number 1437249471
LBN Legal business name Koppel, Carolyn
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2006
Last updated Jul 8th, 2007 - about 17 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 1437249471 NPPES
New York MEDICAID 01972976

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