Organization
COOPER PATHOLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY J. MAZZARELLI M.D. (CHIEF MEDICAL OFFICE)
(856) 968-7858
Entity
Organization
Contact information
Practice address
1 COOPER PLZ, CAMDEN, NJ 08103-1461
(856) 342-2506
(856) 968-8806
Mailing address
1 FEDERAL STREET, SW-200, CAMDEN, NJ 08103-1155
(856) 356-4924
(856) 382-6455
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
—
NJ
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
—
—
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0467269000
AMERIHEALTH
—
05
—
3452808
—
NJ
01
—
88995
AETNA
—
01
—
CE0018
RR MEDICARE
NJ
Enumeration date
06/17/2006
Last updated
07/28/2016
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