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Individual

DR. LEE MATTHEW KUPERSMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
205 FROEHLICH FARM BLVD, WOODBURY, NY 11797-2931
(516) 364-0070
(516) 364-0242
Mailing address
205 FROEHLICH FARM BLVD, WOODBURY, NY 11797-2931
(516) 364-0070
(516) 364-0242

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2118221
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0711521002
CIGNA HEALTH
NY
01
113329150
EMPIRE
NY
01
200029878
RR-MEDICARE
NY
01
4C5675
HEALTHNET
NY
01
508G81
BLUE CROSS BLUE SHEILD
NY
01
596988
596988
NY
01
64383
VYTRA
NY
01
O598917
GHI
NY
01
P2882387
OXFORD
NY
Enumeration date
09/26/2006
Last updated
11/13/2013
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