Individual
DR. STEPHEN J. KUPERBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-3869
Mailing address
800 BIESTERFIELD RD, SUITE 510, ELK GROVE VILLAGE, IL 60007-3367
(847) 981-3660
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2016-01094
NC
207RP1001X
Pulmonary Disease Physician
2016-01094
NC
207RP1001X
Pulmonary Disease Physician
Primary
266079
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036143490
—
IL
Enumeration date
06/18/2009
Last updated
10/15/2018
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