Organization
COOPER UNIVERSITY RADIOLOGY, PC
Active
Organization
COOPER UNIVERSITY RADIOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J. MAZZARELLI M.D. (CHIEF MEDICAL OFFICE)
(856) 968-7858
Entity
Organization
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-2380
(856) 365-0472
Mailing address
1 FEDERAL STREET, SW-200, CAMDEN, NJ 08103-1155
(856) 356-4924
(856) 382-6455
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
—
—
2085N0904X
Nuclear Radiology Physician
—
—
2085P0229X
Pediatric Radiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
NJ
2085R0202X
Diagnostic Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016993
—
NJ
01
—
DB0641
RAILROAD MEDICARE
NJ
Enumeration date
06/06/2006
Last updated
07/27/2016
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