Provider Demographics
NPI:1508965393
Name:POPE, TAMSIN J (DC)
Entity Type:Individual
Prefix:DR
First Name:TAMSIN
Middle Name:J
Last Name:POPE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701-6653
Mailing Address - Country:US
Mailing Address - Phone:716-488-2534
Mailing Address - Fax:716-488-1513
Practice Address - Street 1:25 HARRISON ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701-6653
Practice Address - Country:US
Practice Address - Phone:716-488-2534
Practice Address - Fax:716-488-1513
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004548-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000250512001OtherBLUE CROSS BLUE SHIELD
NY16-1290013-02OtherPRISM HEALTH NETWORKS
NY50512BMedicare ID - Type Unspecified