Individual
JACQUELINE SIERRA COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2546 BALLTOWN RD, SCHENECTADY, NY 12309-1082
(518) 377-8184
Mailing address
47 NEW SCOTLAND AVE DEPT OF, ALBANY, NY 12208-3412
(518) 262-5377
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
312201
NY
390200000X
Student in an Organized Health Care Education/Training Program
499608657
NY
Other
Enumeration date
03/21/2018
Last updated
06/18/2024
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