Provider Demographics
NPI:1861418857
Name:BOPP, JAMES THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:BOPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5600 SUNRISE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1378
Mailing Address - Country:US
Mailing Address - Phone:631-563-7828
Mailing Address - Fax:631-821-7359
Practice Address - Street 1:5600 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1017
Practice Address - Country:US
Practice Address - Phone:631-563-7828
Practice Address - Fax:631-821-7359
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY180716207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY53K321Medicare ID - Type Unspecified
F23990Medicare UPIN