Healthcare Provider Details

I. General information

NPI: 1114348711
Provider Name (Legal Business Name): RACHEL COOPERMAN MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2013
Last Update Date: 06/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ORANGE AVE SUITE 201
LIVINGSTON NJ
07039-5817
US

IV. Provider business mailing address

98 HARTSHORN DR
SHORT HILLS NJ
07078-1634
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-7246
  • Fax:
Mailing address:
  • Phone: 973-951-1596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number26NJ00427600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: