Provider Demographics
NPI:1649377466
Name:POPOWITZ, RICHARD L (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:POPOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 AIRPORT EXECUTIVE PARK
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-5288
Mailing Address - Country:US
Mailing Address - Phone:845-425-0055
Mailing Address - Fax:845-426-6126
Practice Address - Street 1:408 AIRPORT EXECUTIVE PARK
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-5288
Practice Address - Country:US
Practice Address - Phone:845-425-0055
Practice Address - Fax:845-426-6126
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231819-1207X00000X, 207XX0005X
NJ25MA07778700207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0598675OtherGHI-FLEX SELECT
NY601G71OtherEMPIRE BC/BS
NYP3406252OtherOXFORD
NJ081730NLVOtherMEDICARE-NJ
NY3545732OtherUSHC-HMO
NY6854005OtherCIGNA
NYP00154169OtherRAILROAD MEDICARE
NY7420549OtherAETNA-PPO/POS
NY580F11Medicare ID - Type UnspecifiedMEDICARE-NY
NYP00154169OtherRAILROAD MEDICARE