Provider Demographics
NPI:1518304575
Name:TULIN KOPARAN MD PC
Entity Type:Organization
Organization Name:TULIN KOPARAN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TULIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KOPARAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-975-7522
Mailing Address - Street 1:1275 SUMMER ST
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-5359
Mailing Address - Country:US
Mailing Address - Phone:203-975-7522
Mailing Address - Fax:203-975-5233
Practice Address - Street 1:1275 SUMMER ST
Practice Address - Street 2:STE 300A
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-5359
Practice Address - Country:US
Practice Address - Phone:203-975-7522
Practice Address - Fax:203-975-5233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT19213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP00409443OtherRAILROAD PIN
CTP00409443OtherRAILROAD PIN
CT110008788Medicare PIN