Organization
NORTH SHORE MEDICAL GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHU COPPOLA PA (PA)
(315) 289-6300
Entity
Organization
Contact information
Practice address
311 SKYVIEW TER, SYRACUSE, NY 13219-2835
(315) 935-1154
(952) 209-2012
Mailing address
311 SKYVIEW TER, SYRACUSE, NY 13219-2835
(315) 935-1154
(952) 209-2012
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
10/12/2020
Last updated
05/16/2022
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