Individual
DR. MARILENA COOPERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
600 NORTHERN BLVD STE 212, GREAT NECK, NY 11021
(347) 538-1390
Mailing address
475 48TH AVE APT 409, LONG ISLAND CITY, NY 11109-5505
(347) 538-1390
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
293326-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293326-1
MEDICAL LICENSE
NY
Enumeration date
06/23/2014
Last updated
07/11/2018
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