Provider Demographics
NPI:1902217094
Name:KOPEL, MARTIN (DVM)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:
Last Name:KOPEL
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4204
Mailing Address - Country:US
Mailing Address - Phone:718-382-8100
Mailing Address - Fax:718-382-8101
Practice Address - Street 1:3616 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4204
Practice Address - Country:US
Practice Address - Phone:718-382-8100
Practice Address - Fax:718-382-8101
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004678174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian