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Organization
P.T.C MEDICAL, P.C.
Active
Organization
P.T.C MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAOLO THOMAS COPPOLA MD (DC)
(631) 289-0088
Entity
Organization
Contact information
Practice address
79 E MAIN ST, PATCHOGUE, NY 11772-3101
(631) 289-0088
(631) 289-6177
Mailing address
79 E MAIN ST, PATCHOGUE, NY 11772-3101
(631) 289-0088
(631) 289-6177
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
NULL
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
NULL
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
10/17/2006
Last updated
01/28/2015
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