Provider Demographics
NPI:1780607622
Name:LOPASIC, NATALIE WIGHT (MD)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:WIGHT
Last Name:LOPASIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:713 TROY SCHENECTADY RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2490
Mailing Address - Country:US
Mailing Address - Phone:518-690-7020
Mailing Address - Fax:518-690-7022
Practice Address - Street 1:713 TROY SCHENECTADY RD
Practice Address - Street 2:STE 218
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2490
Practice Address - Country:US
Practice Address - Phone:518-690-7020
Practice Address - Fax:518-690-7022
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2016-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY210538207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
10027384OtherCDPHP
2006052510700969OtherMVP
795OtherGROUP CDPHP
BA0016Medicare ID - Type Unspecified
G70539Medicare UPIN