Provider Demographics
NPI:1578766838
Name:POPOWICH, DANIEL ARI (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ARI
Last Name:POPOWICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2200 NORTHERN BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-1221
Mailing Address - Country:US
Mailing Address - Phone:516-627-5262
Mailing Address - Fax:516-627-0641
Practice Address - Street 1:2200 NORTHERN BLVD STE 125
Practice Address - Street 2:
Practice Address - City:GREENVALE
Practice Address - State:NY
Practice Address - Zip Code:11548-1221
Practice Address - Country:US
Practice Address - Phone:516-627-5262
Practice Address - Fax:516-627-0641
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2019-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY260854208600000X
IL036.118399208600000X
MA249525208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery