Organization
COOPER PRIMARY CARE AT PENNSVILLE, PA
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
390 NORTH BROAD STREET, CONCORD PROFESSIONAL BUILDING, STE 100, PENNSVILLE, NJ 08070
(856) 678-6411
(856) 678-7509
Mailing address
1 FEDERAL STREET, SW-200, CAMDEN, NJ 08103-1155
(856) 356-4924
(856) 382-6455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NJ
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0479412001
AMERIHEALTH
—
01
—
15096
AETNA
—
05
—
7209908
—
NJ
Enumeration date
08/01/2006
Last updated
07/27/2016
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