Individual
CASSANDRA COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2202 CONCORD ST, MALTA, NY 12020-5265
(845) 642-7680
Mailing address
2202 CONCORD ST, MALTA, NY 12020-5265
(845) 642-7680
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
012556-01
NY
Other
Enumeration date
10/27/2020
Last updated
11/01/2020
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