Organization
COOPER PEDIATRIC SPECIALISTS
Active
Parent organization
COOPER PEDIATRIC SPECIALISTS
Organization subpart
Yes
Provider details
NPI number
Legal business name
COOPER PEDIATRIC SPECIALISTS
Authorized official
ROBERT MCMULLEN (EVP MANAGED CARE)
(856) 342-7263
Entity
Organization
Contact information
Practice address
3 COOPER PLZ, SUITE 200, CAMDEN, NJ 08103-1438
(856) 342-2001
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 968-7433
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125255000
AMERIHEALTH GRP NUMBER
—
05
—
9024603
—
NJ
Enumeration date
03/14/2007
Last updated
08/30/2007
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