Organization
COOPER SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J. MAZZERELLI M.D. (CHIEF MEDICAL OFFICE)
(856) 968-7858
Entity
Organization
Contact information
Practice address
3 COOPER PLZ, SUITE 411, CAMDEN, NJ 08103-1438
(856) 342-3321
(856) 968-8611
Mailing address
1 FEDERAL STREET, SW-200, CAMDEN, NJ 08103-1155
(856) 356-4924
(856) 382-6455
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
—
—
207NS0135X
Procedural Dermatology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208200000X
Plastic Surgery Physician
—
—
208600000X
Surgery Physician
Primary
—
NJ
208600000X
Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00787539
—
PA
01
—
0081095000
AMERIHEALTH GROUP NUMBER
—
05
—
2865807
—
NJ
05
—
3285316
—
NJ
05
—
7161701
—
NJ
Enumeration date
06/01/2006
Last updated
09/10/2024
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