Individual
EBONY R COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(773) 296-8250
Mailing address
85 W BURNSIDE AVE, BRONX, NY 10453-4015
(718) 483-1270
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
275661
NY
Other
Enumeration date
04/28/2009
Last updated
08/13/2014
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