Individual
PAUL J COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 DURHAM RD, SUITE 1, MADISON, CT 06443-2674
(203) 245-8035
(203) 245-4315
Mailing address
340 MAIN ST, STE 670, WORCESTER, MA 01608-1604
(508) 754-3566
(508) 438-6364
Taxonomy
Speciality
Code
Description
License number
State
207VE0102X
Reproductive Endocrinology Physician
015953
CT
207VG0400X
Gynecology Physician
Primary
015953
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001159532
—
CT
Enumeration date
07/09/2005
Last updated
10/05/2011
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