Provider Demographics
NPI:1992543730
Name:HOPECK, DEANA
Entity type:Individual
Prefix:
First Name:DEANA
Middle Name:
Last Name:HOPECK
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 1:32 WILMER AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:COHOES
Mailing Address - State:NY
Mailing Address - Zip Code:12047-4111
Mailing Address - Country:US
Mailing Address - Phone:518-605-4478
Mailing Address - Fax:
Practice Address - Street 1:32 WILMER AVE APT 2
Practice Address - Street 2:
Practice Address - City:COHOES
Practice Address - State:NY
Practice Address - Zip Code:12047-4111
Practice Address - Country:US
Practice Address - Phone:518-605-4478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY764186163W00000X
MARN2368431163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse