Individual
MR. ILYA KOPACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2520 BATCHELDER ST APT 5H, BROOKLYN, NY 11235-1545
(347) 760-7684
Mailing address
2520 BATCHELDER ST, BROOKLYN, NY 11235-1553
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
656739
NY
363L00000X
Nurse Practitioner
Primary
343781
NY
Other
Enumeration date
11/26/2021
Last updated
11/26/2021
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