Provider Demographics
NPI:1245447135
Name:KUPFERMAN, SANDRA (DMD)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:KUPFERMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 1ST AVE
Mailing Address - Street 2:APT 32A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3700
Mailing Address - Country:US
Mailing Address - Phone:212-684-2428
Mailing Address - Fax:
Practice Address - Street 1:36 W 44TH ST
Practice Address - Street 2:SUITE905
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-8102
Practice Address - Country:US
Practice Address - Phone:212-768-4091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0477521223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics