MEDICARE: DR. AMBER ROSE 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	38MC00650100	NJ

General Provider Information

NPI Number	:	1588713572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBER ROSE COPPOLA D.C.

Provider Business Mailing Address
First Line	:	6601 VENTNOR AVE STE 302
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-2170
Country	:	US
Telephone Number	:	609-369-0378
Fax Number	:

Provider Business Practice Location Address
First Line	:	6601 VENTNOR AVE STE 302
Second Line	:
City	:	VENTNOR CITY
State	:	NJ
Zip	:	08406-2170
Country	:	US
Telephone Number	:	609-369-0378
Fax Number	:

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	10/07/2025

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