Provider Demographics
NPI:1215227699
Name:ROPECKA, ADRIENNE
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:ROPECKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:FOSEGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40 FRONT ST. SUITE C
Mailing Address - Street 2:RIVERSIDE ASSOCIATES IN ANESTHESIA
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905
Mailing Address - Country:US
Mailing Address - Phone:607-722-7264
Mailing Address - Fax:607-722-7869
Practice Address - Street 1:169 RIVERSIDE DRIVE
Practice Address - Street 2:LOURDES HOSPITAL
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905
Practice Address - Country:US
Practice Address - Phone:607-722-7264
Practice Address - Fax:607-722-7869
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY577275163W00000X
NC087389367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse