Individual
VICTORIA COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
40 BEY LEA RD, SUITE B203, TOMS RIVER, NJ 08753-2900
(732) 341-0720
Mailing address
12 LANCELOT LN, MOUNT LAUREL, NJ 08054-1913
(856) 206-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00426200
NJ
Other
Enumeration date
03/05/2017
Last updated
03/05/2017
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