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General NPI Number Information
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NPI Number | 1316977531
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Entity Type | Individual
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Provider Name | JAY S COOPERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 08/18/2014
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Provider Practice Location Address
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Address Line | 30 S VALLEY RD SUITE 280
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City | PAOLI
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State | PA
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Zip | 19301-1450
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Country | US
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Telephone | 610-644-0477
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Fax | 610-644-4161
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Provider Business Mailing Address
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Address Line | 30 S VALLEY RD SUITE 208
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City | PAOLI
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State | PA
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Zip | 19301-1450
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Country | US
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Telephone | 610-644-0477
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Fax | 610-644-4161
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD027478E
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License Number State | PA
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