Provider Demographics
NPI:1689655524
Name:COPELAND, ARTHUR M (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:M
Last Name:COPELAND
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:204 S RIDGE ST
Mailing Address - Street 2:
Mailing Address - City:RYE BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:10573-3434
Mailing Address - Country:US
Mailing Address - Phone:914-939-0830
Mailing Address - Fax:914-939-7029
Practice Address - Street 1:204 S RIDGE ST
Practice Address - Street 2:
Practice Address - City:RYE BROOK
Practice Address - State:NY
Practice Address - Zip Code:10573-3434
Practice Address - Country:US
Practice Address - Phone:914-939-0830
Practice Address - Fax:914-939-7029
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT002716152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU29111Medicare UPIN
NYC45221Medicare PIN
NY410036152Medicare PIN