Organization
VPC MEDSPA 1 LLC
Active
Other names
Bare Aesthetic
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA COPPOLA A.P.N. (OWNER)
(201) 564-7521
Entity
Organization
Contact information
Practice address
200 CLOSTER DOCK RD FL 2, CLOSTER, NJ 07624-1928
(201) 564-7521
Mailing address
26 PARK ST STE 2058, MONTCLAIR, NJ 07042-3443
(201) 564-7521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
05/24/2020
Last updated
05/24/2020
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