Provider Demographics
NPI:1215765474
Name:POPICK, ARIELLA L
Entity type:Individual
Prefix:
First Name:ARIELLA
Middle Name:L
Last Name:POPICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 VICTORY BLVD STE 14A
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-3509
Mailing Address - Country:US
Mailing Address - Phone:917-443-6494
Mailing Address - Fax:
Practice Address - Street 1:97 NEW DORP LN STE D
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2364
Practice Address - Country:US
Practice Address - Phone:646-389-0325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030777225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist