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General NPI Number Information
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NPI Number | 1285662460
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Entity Type | Individual
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Provider Name | JOSEPH A COPPOLA RPA-C
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Gender | Male
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1616 KENSINGTON AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1433
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Country | US
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Telephone | 716-835-3097
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Fax | 716-837-4654
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Provider Business Mailing Address
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Address Line | 1616 KENSINGTON AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1433
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Country | US
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Telephone | 716-835-3097
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Fax | 716-837-4654
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 007540
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License Number State | NY
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