Basic Information
Provider Information
NPI: 1073698767
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: POPLIN
FirstName: ELIZABETH
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 120 ALBANY STREET
Address2: TOWER 2, 7TH FLOOR
City: NEW BRUNSWICK
State: NJ
PostalCode: 089012126
CountryCode: US
TelephoneNumber: 7329378537
FaxNumber: 7329378941
Practice Location
Address1: 1 ROBERT WOOD JOHNSON PLACE
Address2:  
City: NEW BRUNSWICK
State: NJ
PostalCode: 089031928
CountryCode: US
TelephoneNumber: 7322357840
FaxNumber: 7322357048
Other Information
ProviderEnumerationDate: 10/25/2006
LastUpdateDate: 01/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RX0202X25MA064963NJN Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
207RX0202X25MA06496300NJY Allopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology

ID Information
IDTypeStateIssuerDescription
715180205NJ MEDICAID


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