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General NPI Number Information
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NPI Number | 1003510439
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Entity Type | Individual
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Provider Name | TONY COPLIN
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Gender | Male
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Dates
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Enumeration Date | 03/29/2023
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 5334 N SYDENHAM ST
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1620
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Country | US
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Telephone | 267-734-6853
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Fax |
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Provider Business Mailing Address
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Address Line | 5334 N SYDENHAM ST
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City | PHILADELPHIA
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State | PA
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Zip | 19141-1620
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Country | US
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Telephone | 267-734-6853
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 68953601
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 376J00000X
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Taxonomy Name | Homemaker
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License Number | 68953601
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 68953601
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License Number State | PA
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