Provider Demographics
NPI:1275575409
Name:POPKIN, VALERIE (MD)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:POPKIN
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 1:196 PARKWAY SOUTH
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385
Mailing Address - Country:US
Mailing Address - Phone:860-443-4383
Mailing Address - Fax:860-443-3980
Practice Address - Street 1:196 PARKWAY S
Practice Address - Street 2:SUITE 103
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-1234
Practice Address - Country:US
Practice Address - Phone:860-443-4383
Practice Address - Fax:860-443-3980
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT38610207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
06-1616101OtherCOMM. HEALTH NETWORK/ECCD
06-1616101OtherUNITHEDHEALTHCARE/ECCD
0V7346OtherHEALTHNET/ECCG:06-1049086
010038610CT01OtherANTHEM/ECCG:06-1049086
500HBC444CT01OtherANTHEM/HOSP-BASED ECCD
P2069799OtherOXFORD/ECCG: 06-1049086
P2524335OtherOXFORD/ECCD: 06-1616101
06-1049086OtherCOMM HEALTH NETWORK/ECCG
06-1049086OtherUNITEDHEALTHCARE/ECCG
060059639OtherRR MED/ECCG:06-1049086
CT001386102Medicaid
038610OtherCONNECTICARE
060064818OtherRR MED/ECCD:06-1616101
010038610CT04OtherANTHEM/ECCD: 06-1616101
001002815OtherBLUECARE FAMILY PLAN
0V9739OtherHEALTHNET/ECCD:06-1616101
001002815OtherBLUECARE FAMILY PLAN
0V7346OtherHEALTHNET/ECCG:06-1049086
060001430Medicare ID - Type UnspecifiedECCD: 06-1616101