Provider Demographics
NPI:1407054109
Name:COOPERMAN, ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:
Last Name:COOPERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:200 SOUTH ORANGE AVE
Mailing Address - Street 2:SUITE 155
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039
Mailing Address - Country:US
Mailing Address - Phone:973-994-2021
Mailing Address - Fax:973-488-7156
Practice Address - Street 1:200 SOUTH ORANGE AVE
Practice Address - Street 2:SUITE 155
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039
Practice Address - Country:US
Practice Address - Phone:973-994-2021
Practice Address - Fax:973-488-7156
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-05
Last Update Date:2016-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA087375002086S0122X
KY414472086S0122X
NJ25MA08737800208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery