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NPI Code Detail

MEDICARE: SANFORD COOPER MD

MEDICARE:   SANFORD  COOPER  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology Physician25MA04597300NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1326013202
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANFORD COOPER MD
Provider Business Mailing Address
First Line : 111 NORTHFIELD AVE
Second Line : STE 311
City : WEST ORANGE
State : NJ
Zip : 07052-4703
Country : US
Telephone Number : 973-325-2103
Fax Number : 973-325-2254
Provider Business Practice Location Address
First Line : 111 NORTHFIELD AVE
Second Line : STE 311
City : WEST ORANGE
State : NJ
Zip : 07052-4703
Country : US
Telephone Number : 973-325-2103
Fax Number : 973-325-2254
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/22/2006
Last Update Date : 03/07/2012

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Directions to “ SANFORD COOPER MD” Practice Location

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