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General NPI Number Information
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NPI Number | 1982409439
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Entity Type | Individual
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Provider Name | LUKAS COOPER PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/18/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 141 ROUTE 70, SUITE B RENAISSANCE SQUARE
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City | MARLTON
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State | NJ
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Zip | 08053
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Country | US
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Telephone | 856-596-9057
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Fax | 856-596-0837
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Provider Business Mailing Address
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Address Line | 301 LIPPINCOTT DR STE 410
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City | MARLTON
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State | NJ
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Zip | 08053-4197
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Country | US
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Telephone | 856-596-9057
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Fax | 856-596-0837
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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 | 25MP00914000
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License Number State | NJ
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