Provider Demographics
NPI:1568413300
Name:KOPELL, BRIAN H (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:KOPELL
Suffix:
Gender:M
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:ONE GUSTAVE L. LEVY PLACE, BOX 1136
Mailing Address - Street 2:MOUNT SINAI HOSPITAL
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-0050
Mailing Address - Fax:212-410-0603
Practice Address - Street 1:5 EAST 98 STREET
Practice Address - Street 2:NEUROSURGERY FACULTY ASSOCIATES
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029
Practice Address - Country:US
Practice Address - Phone:212-241-0050
Practice Address - Fax:212-410-0603
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI47197207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34560900Medicaid
NYA400067904OtherMEDICARE
029906261POtherHUMANA
NY03441072Medicaid
WI34560900Medicaid
NY03441072Medicaid