Organization
COOPER SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN E BEKES MD (CHIEF MEDICAL OFFICER, SEVP)
(856) 963-6888
Entity
Organization
Contact information
Practice address
2 PLAZA DR, BUILDING 2, SUITE 203, SEWELL, NJ 08080-9207
(856) 270-4100
(856) 270-4012
Mailing address
3 COOPER PLZ, SUITE 502, CAMDEN, NJ 08103-1438
(856) 963-6888
(856) 968-8499
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0820570000
AMERIHEALTH PROVIDER GROUP NUMBER
NJ
Enumeration date
06/24/2011
Last updated
06/24/2011
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