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General NPI Number Information
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NPI Number | 1457970931
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Entity Type | Individual
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Provider Name | DR. ANDREW THOMAS COPPA
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Gender | Male
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Dates
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Enumeration Date | 04/14/2020
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1505 W SHERMAN AVE
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City | VINELAND
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State | NJ
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Zip | 08360-7059
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Country | US
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Telephone | 856-641-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 44 W PARSONAGE WAY
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City | MANALAPAN
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State | NJ
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Zip | 07726-7903
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Country | US
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Telephone |
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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 | 1835E0208X
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Taxonomy Name | Emergency Medicine Pharmacist
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License Number | 2023020244
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 2023020244
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License Number State | MO
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 25MB11701400
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License Number State | NJ
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