Provider Demographics
NPI:1497781041
Name:KOPEL, DAWN
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:KOPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:
Other - Last Name:WEINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2 CHURCH ST S
Mailing Address - Street 2:#209
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1717
Mailing Address - Country:US
Mailing Address - Phone:203-787-2264
Mailing Address - Fax:203-497-9354
Practice Address - Street 1:2 CHURCH ST S
Practice Address - Street 2:#209
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1717
Practice Address - Country:US
Practice Address - Phone:203-787-2264
Practice Address - Fax:203-497-9354
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT038155207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTG62713Medicare UPIN