Provider Demographics
NPI:1568474021
Name:POPILEVSKY, LAZAR (MD)
Entity Type:Individual
Prefix:
First Name:LAZAR
Middle Name:
Last Name:POPILEVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:105 KINGS HWY
Mailing Address - Street 2:SUITE #3D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-1525
Mailing Address - Country:US
Mailing Address - Phone:646-623-4140
Mailing Address - Fax:718-331-8627
Practice Address - Street 1:535 SECOND AVENUE
Practice Address - Street 2:KIPS BAY ENDOSCOPY CENTER LLC
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8275
Practice Address - Country:US
Practice Address - Phone:212-889-5477
Practice Address - Fax:212-889-0517
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-12-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY218701207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02191697Medicaid
NY02191697Medicaid
NYH51769Medicare UPIN