Provider Demographics
NPI:1760541726
Name:JOSEPH F POPOVICH, M.D., P.C.
Entity Type:Organization
Organization Name:JOSEPH F POPOVICH, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR - OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:POPOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-209-9110
Mailing Address - Street 1:159 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1113
Mailing Address - Country:US
Mailing Address - Phone:201-209-9110
Mailing Address - Fax:201-432-5142
Practice Address - Street 1:159 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1113
Practice Address - Country:US
Practice Address - Phone:201-209-9110
Practice Address - Fax:201-432-5142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA531442086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5657202Medicaid
NJ033104Medicare ID - Type Unspecified
NJF60423Medicare UPIN