Organization
COOPER UNIVERSITY TRAUMA PHYSICIANS, 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) 342-3014
(856) 342-2817
Mailing address
1 FEDERAL STREET, SW-200, CAMDEN, NJ 08103-1155
(856) 356-4924
(856) 382-6455
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
2086S0127X
Trauma Surgery Physician
Primary
—
NJ
2086S0127X
Trauma Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060542
—
NJ
01
—
2283236000
AMERIHEALTH/KEYSTONE/IBC
NJ
01
—
3308828
AETNA GRP NUMBER
NJ
Enumeration date
06/05/2006
Last updated
07/27/2016
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