Healthcare Provider Details

I. General information

NPI: 1952389082
Provider Name (Legal Business Name): CHRISTOPHER COPPOLA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 03/12/2025
Certification Date: 03/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEISINGER MEDICAL CTR 100 N. ACADEMY AV. MC 21-70
DANVILLE PA
17822-2170
US

IV. Provider business mailing address

GEISINGER MEDICAL CTR 100 N. ACADEMY AV. MC 21-70
DANVILLE PA
17822-2170
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6361
  • Fax: 570-271-5785
Mailing address:
  • Phone: 570-271-6361
  • Fax: 570-271-5785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number25MA10691900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number19950
License Number StateNH
# 3
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License Number25MA10691900
License Number StateNJ
# 4
Primary TaxonomyY
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberMD435739
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: