Basic Information
| Provider Information | |||||||||
| NPI: | 1053623272 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | POPIVKER | ||||||||
| FirstName: | ZOYA | ||||||||
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| NamePrefix: | DR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF PSYCHIATRY | ||||||||
| Address2: | PUTNAM HALL, SUNY AT STONY BROOK | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316328850 | ||||||||
| FaxNumber: | 6316324448 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF PSYCHIATRY | ||||||||
| Address2: | PUTNAM HALL, SUNY AT STONY BROOK | ||||||||
| City: | STONY BROOK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117948790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6316328850 | ||||||||
| FaxNumber: | 6316324448 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/02/2010 | ||||||||
| LastUpdateDate: | 09/01/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | 263231 | NY | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0804X | 263231 | NY | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.