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General NPI Number Information
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NPI Number | 1902356207
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Entity Type | Individual
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Provider Name | RACHEL LINDSAY COOPER PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/11/2016
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 443 NORTHFIELD AVE STE 204
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City | WEST ORANGE
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State | NJ
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Zip | 07052-3093
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Country | US
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Telephone | 732-246-3066
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Fax |
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Provider Business Mailing Address
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Address Line | 402 LIPPINCOTT DR
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City | MARLTON
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State | NJ
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Zip | 08053-4112
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Country | US
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Telephone | 856-782-3300
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 25MP00630700
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License Number State | NJ
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