Individual
POPPY ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
256 MASON AVE FL 3, STATEN ISLAND, NY 10305-3408
(718) 226-6398
Mailing address
256 MASON AVE FL 3, STATEN ISLAND, NY 10305-3408
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
333393
NY
208C00000X
Colon & Rectal Surgery Physician
73768
MN
Other
Enumeration date
03/21/2018
Last updated
02/25/2025
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