# DR. THOMAS B COPPENS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538141601
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 181652 | NY | Yes |

## Other

- **Enumeration date:** 11/15/2005
- **Last updated:** 02/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00020889501 | UNIVERA | NY |
| 01 | — | 000401237001 | BLUE SHIELD WNY | NY |
| 01 | — | 002120070020 | FIDELIS | NY |
| 05 | — | 01234835 | — | NY |
| 01 | — | 08159 | MVP | NY |
| 01 | — | 10000396 | CDPHP | NY |
| 01 | — | 10492712 | CAQH | NY |
| 01 | — | 46978 | GHI HMO | NY |
| 01 | — | 5639199 | AETNA | NY |
| 01 | — | 56402A | MEDICARE GROUP NUMBER | NY |
| 01 | — | 5900204 | GHI | NY |
| 01 | — | 79F711 | BLUE CROSS BLUE SHIELD | NY |
| 01 | — | CD1981 | RAILROAD MEDICARE GROUP \# | — |
| 01 | — | NY22884 | TRICARE | NY |