Active NPI
Mark Kopetskie
- Pharmacist
- Bethlehem, PA
National Provider Identifier
1104427939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP035978L
- Practice address
- 3926 Linden St
Bethlehem, PA 18020-5846 - Phone
- (610) 882-1593
- NPI assigned
- Nov 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RIO2676900 | NJ | |
| Pharmacist | 183500000X | RP035978L | PA | Primary |
Addresses
Primary practice location
3926 Linden St
Bethlehem, PA 18020-5846
Mailing address
3926 Linden St
Bethlehem, PA 18020-5846
Phone (610) 882-1593
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RIO2676900 | NJ | MD | Pharmacist |
| RP035978L | PA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1604620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1604620800000",
"number": "1104427939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3926 LINDEN ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180205846",
"telephone_number": "610-882-1593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3926 LINDEN ST",
"city": "BETHLEHEM",
"state": "PA",
"postal_code": "180205846",
"telephone_number": "610-882-1593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOPETSKIE",
"first_name": "MARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-11-06",
"last_updated": "2020-11-06",
"certification_date": "2020-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RIO2676900",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "PA",
"license": "RP035978L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethlehem, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.