Provider Demographics
NPI:1316535727
Name:COPE AND FEDULLO MEDICAL SERVICES PLLC
Entity Type:Organization
Organization Name:COPE AND FEDULLO MEDICAL SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:COPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-669-1439
Mailing Address - Street 1:PO BOX 343
Mailing Address - Street 2:
Mailing Address - City:BROADALBIN
Mailing Address - State:NY
Mailing Address - Zip Code:12025-0343
Mailing Address - Country:US
Mailing Address - Phone:518-669-1439
Mailing Address - Fax:844-612-1926
Practice Address - Street 1:1728 STATE HIGHWAY 29 STE 1
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-6760
Practice Address - Country:US
Practice Address - Phone:518-669-1439
Practice Address - Fax:844-612-1926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-02
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty