Provider Demographics
NPI:1033723382
Name:KUPERSHTEYN, RIMMA
Entity Type:Individual
Prefix:
First Name:RIMMA
Middle Name:
Last Name:KUPERSHTEYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 OCEANA DR E APT 4C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6682
Mailing Address - Country:US
Mailing Address - Phone:917-912-1100
Mailing Address - Fax:
Practice Address - Street 1:32 UNION SQ E STE 603
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3243
Practice Address - Country:US
Practice Address - Phone:212-539-1690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006784171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist