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General NPI Number Information
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NPI Number | 1023010006
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Entity Type | Individual
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Provider Name | GARY ALAN COOPERSTEIN D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 09/18/2024
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Provider Practice Location Address
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Address Line | 14826 S MILITARY TRL STE 14826
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8153
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Country | US
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Telephone | 561-496-5677
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Fax |
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Provider Business Mailing Address
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Address Line | 14826 S MILITARY TRL STE 14826
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City | DELRAY BEACH
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State | FL
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Zip | 33484-8153
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Country | US
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Telephone | 561-496-5677
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS-005991-L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS15659
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License Number State | FL
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