Provider Demographics
NPI:1063592285
Name:POPOVICH, JOSEPH FRANCIS (MD,FACS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:POPOVICH
Suffix:
Gender:M
Credentials:MD,FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 PALISADE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-1113
Mailing Address - Country:US
Mailing Address - Phone:201-209-9110
Mailing Address - Fax:
Practice Address - Street 1:159 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1113
Practice Address - Country:US
Practice Address - Phone:201-209-9110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA053144208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208600000XAllopathic & Osteopathic PhysiciansSurgery
Not Answered2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5657202Medicaid
NJF60423Medicare UPIN
NJ033104Medicare ID - Type Unspecified