Provider Demographics
NPI:1801052261
Name:LOPUSHNYAN, NATALYA A (MD)
Entity type:Individual
Prefix:DR
First Name:NATALYA
Middle Name:A
Last Name:LOPUSHNYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 LIBERTY ST APT 2804
Mailing Address - Street 2:
Mailing Address - City:BRAINTREE
Mailing Address - State:MA
Mailing Address - Zip Code:02184-7387
Mailing Address - Country:US
Mailing Address - Phone:617-620-1535
Mailing Address - Fax:
Practice Address - Street 1:31 ROCHE BROTHERS WAY STE 100
Practice Address - Street 2:
Practice Address - City:NORTH EASTON
Practice Address - State:MA
Practice Address - Zip Code:02356-1032
Practice Address - Country:US
Practice Address - Phone:508-238-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-05
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML60021030208800000X
MA259210208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology