Provider Demographics
NPI:1902017882
Name:NATALIE W LOPASIC
Entity Type:Organization
Organization Name:NATALIE W LOPASIC
Other - Org Name:DBA: NORTHEAST EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOPASIC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-690-7020
Mailing Address - Street 1:711 TROY-SCHENECTADY RD.
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2454
Mailing Address - Country:US
Mailing Address - Phone:518-690-7020
Mailing Address - Fax:518-690-7022
Practice Address - Street 1:711 TROY-SCHENECTADY RD.
Practice Address - Street 2:SUITE 109
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2454
Practice Address - Country:US
Practice Address - Phone:518-690-7020
Practice Address - Fax:518-690-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBA0016Medicare UPIN
NYBA0016Medicare PIN