Basic Information
Provider Information
NPI: 1528355179
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POPPER
FirstName: JOSEPH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
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OtherCredential:  
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Mailing Information
Address1: 5010 STATE HIGHWAY 30
Address2: STE 205
City: AMSTERDAM
State: NY
PostalCode: 120107532
CountryCode: US
TelephoneNumber: 5188422663
FaxNumber: 5188424861
Practice Location
Address1: 5010 STATE HIGHWAY 30
Address2: STE 205
City: AMSTERDAM
State: NY
PostalCode: 120107532
CountryCode: US
TelephoneNumber: 5188422663
FaxNumber: 5188424861
Other Information
ProviderEnumerationDate: 07/05/2011
LastUpdateDate: 05/14/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X289182NYY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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