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Individual

MR. ANTHONY COPPOLA JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.A.

Contact information

Practice address
201 PRESIDENT ST, HEMPSTEAD, NY 11550-4718
(516) 292-7111
Mailing address
436A FRONT ST, HEMPSTEAD, NY 11550-4212
(516) 292-7111

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
003091
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003091
NY
Enumeration date
01/31/2013
Last updated
01/31/2013
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