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General NPI Number Information
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NPI Number | 1649217514
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Entity Type | Organization
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Legal Business Name | COOPER SURGICAL ASSOCIATES, PA
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 3 COOPER PLZ SUITE 411
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City | CAMDEN
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State | NJ
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Zip | 08103-1438
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Country | US
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Telephone | 856-342-3321
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Fax | 856-968-8611
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Provider Business Mailing Address
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Address Line | 1 FEDERAL STREET SW-200
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City | CAMDEN
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State | NJ
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Zip | 08103-1155
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Country | US
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Telephone | 856-356-4924
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Fax | 856-382-6455
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICE
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Name | ANTHONY J. MAZZERELLI
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Credential | M.D.
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Telephone | 856-968-7858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | NJ
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