Individual
PAOLO THOMAS COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
519 W JERICHO TPKE, SMITHTOWN, NY 11787-2619
(631) 360-5900
(631) 360-9406
Mailing address
100 GRANNY RD, STE 1, FARMINGVILLE, NY 11738-2879
(631) 360-5900
(631) 360-9406
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
207790
NY
207QA0401X
Addiction Medicine (Family Medicine) Physician
207790
NY
Other
Enumeration date
05/17/2006
Last updated
02/10/2019
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