Provider Demographics
NPI:1033238423
Name:KUPERWASSER, BRIGITTE (MD)
Entity Type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:
Last Name:KUPERWASSER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HAWTHORNE PL
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2343
Mailing Address - Country:US
Mailing Address - Phone:609-730-3219
Mailing Address - Fax:
Practice Address - Street 1:1125 TRENTON HARBOURTON RD
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08560-1504
Practice Address - Country:US
Practice Address - Phone:609-730-3219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58676207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology