Provider Demographics
NPI:1003113986
Name:POPESKI, FRED J
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:J
Last Name:POPESKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5291 W 52ND ST
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW
Mailing Address - State:PA
Mailing Address - Zip Code:16415-2334
Mailing Address - Country:US
Mailing Address - Phone:814-836-9955
Mailing Address - Fax:
Practice Address - Street 1:4508 ZUCK RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-4523
Practice Address - Country:US
Practice Address - Phone:814-323-2104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-11
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath