Provider Demographics
NPI:1598855645
Name:POPEK, YVONNE ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:ELIZABETH
Last Name:POPEK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 WOOD CREEK DR
Mailing Address - Street 2:APT. G
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-7706
Mailing Address - Country:US
Mailing Address - Phone:617-645-5518
Mailing Address - Fax:
Practice Address - Street 1:5807 ROME-TABERG RD.
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440
Practice Address - Country:US
Practice Address - Phone:315-336-4135
Practice Address - Fax:315-336-4585
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV006943152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist