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General NPI Number Information
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NPI Number | 1356439988
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Entity Type | Individual
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Provider Name | CHARLES CARMEN COPPOLA D.C.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 11/18/2011
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Provider Practice Location Address
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Address Line | 1 S STONE AVE
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City | ELMSFORD
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State | NY
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Zip | 10523-3612
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Country | US
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Telephone | 914-592-1733
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Fax | 914-347-2183
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Provider Business Mailing Address
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Address Line | 1 S STONE AVE
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City | ELMSFORD
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State | NY
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Zip | 10523-3612
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Country | US
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Telephone | 914-592-1733
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Fax | 914-347-2183
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | X3723
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License Number State | NY
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