Provider Demographics
NPI:1164520102
Name:POPLARSKI, JEFFREY EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:EDWARD
Last Name:POPLARSKI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 477
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-0477
Mailing Address - Country:US
Mailing Address - Phone:631-598-7034
Mailing Address - Fax:631-598-7479
Practice Address - Street 1:217 MERRICK RD
Practice Address - Street 2:SUITE 204
Practice Address - City:AMITYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11701-3449
Practice Address - Country:US
Practice Address - Phone:631-598-7034
Practice Address - Fax:631-598-7479
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY753003644OtherTAX ID NUMBER
NY753003644OtherTAX ID NUMBER