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Individual

DR. ELIYAHU SAMUEL KOPSTICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O

Contact information

Practice address
2315 VICTORY BLVD, STATEN ISLAND, NY 10314-6623
(718) 477-6900
(718) 477-7862
Mailing address
2315 VICTORY BLVD, STATEN ISLAND, NY 10314-6623
(718) 477-6900
(718) 477-7862

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
235575
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000116248
GHI HMO
NY
01
0145896
GHI PPO
NY
01
0414219
EVERCARE
NY
01
1466245
AETNA HMO#
NY
01
235575
HIP
NY
01
348ST1
EMPIRE BCBS
NY
01
5C7787
HEALTHNET ID#
NY
01
7270822
AETNA PPO#
NY
01
KE5575
ATLANTIS HEALTH PLAN
NY
01
P3808101
OXFORD ID#
NY
Enumeration date
05/24/2006
Last updated
03/27/2008
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