Provider Demographics
NPI:1659340859
Name:KOPLIN, RICHARD S (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:KOPLIN
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 1:310 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4201
Mailing Address - Country:US
Mailing Address - Phone:212-505-6550
Mailing Address - Fax:212-979-1772
Practice Address - Street 1:310 E 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4201
Practice Address - Country:US
Practice Address - Phone:212-505-6550
Practice Address - Fax:212-979-1772
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106488207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1C2534OtherHEALTH NET
NY181922032OtherPALMETTO ID
NY313619OtherUNITED HC ID
NY96309OtherAETNA ID
NY0055800OtherGHI ID
NY106488B40OtherHEALTH FIRST
NY169940OtherELDERPLAN ID
NY51414OtherVYTRA ID
NYM6755POtherHIP ID
NY00186934Medicaid
NY539161OtherBCBS ID
NYNS411OtherOXFORD ID
NY0055800OtherGHI ID
NY539161OtherBCBS ID