MEDICARE: DR. FRANK JOHN COPPOLA D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	X003465	NY

General Provider Information

NPI Number	:	1043337116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK JOHN COPPOLA D.C.

Provider Business Mailing Address
First Line	:	272 JESSAMINE AVE
Second Line	:
City	:	YONKERS
State	:	NY
Zip	:	10701-5620
Country	:	US
Telephone Number	:	914-963-3357
Fax Number	:	718-828-0203

Provider Business Practice Location Address
First Line	:	2046 EASTCHESTER RD
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-2240
Country	:	US
Telephone Number	:	718-931-7010
Fax Number	:	718-828-0203

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	07/08/2007

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