Healthcare Provider Details

I. General information

NPI: 1447207147
Provider Name (Legal Business Name): COOPER ANESTHESIA ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 07/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 COOPER PLZ SUITE 314
CAMDEN NJ
08103-1438
US

IV. Provider business mailing address

1 FEDERAL STREET SW-200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-963-6770
  • Fax: 856-968-8240
Mailing address:
  • Phone: 856-356-4924
  • Fax: 856-382-6455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateNJ

VIII. Authorized Official

Name: ANTHONY J. MAZZARELLI
Title or Position: CHIEF MEDICAL OFFICE
Credential: M.D.
Phone: 856-968-7858