Individual
DEVIN COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4615 NORTH ST, JAMESVILLE, NY 13078-9499
(315) 469-7600
(315) 469-7775
Mailing address
PO BOX 340, NEW HARTFORD, NY 13413-0340
(315) 732-9368
(315) 732-9403
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
201412-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01964130
—
NY
Enumeration date
06/06/2006
Last updated
03/07/2023
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