Healthcare Provider Details

I. General information

NPI: 1922552306
Provider Name (Legal Business Name): HANNAH COPPOLA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH WEINREB

II. Dates (important events)

Enumeration Date: 08/15/2016
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 121Q
BEVERLY MA
01915-6129
US

IV. Provider business mailing address

100 CUMMINGS CTR STE 121Q
BEVERLY MA
01915-6129
US

V. Phone/Fax

Practice location:
  • Phone: 978-907-0907
  • Fax:
Mailing address:
  • Phone: 978-927-0907
  • Fax: 978-927-0537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number22405
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: