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General NPI Number Information
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NPI Number | 1265466494
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Entity Type | Organization
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Legal Business Name | MARGUERITE L. COPPENS, MD
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 565 N FOREST RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4935
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Country | US
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Telephone | 716-632-4045
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Fax | 716-632-6908
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Provider Business Mailing Address
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Address Line | 565 N FOREST RD
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-4935
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Country | US
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Telephone | 716-632-4045
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Fax | 716-632-6908
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Authorized Official
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Title or Position | OWNER, PHYSICIAN
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Name | MARGUERITE L COPPENS
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Credential | M.D.
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Telephone | 716-632-4045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 158086-1
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License Number State | NY
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