Provider Demographics
NPI:1538318258
Name:COPPOLECCHIA, ROSA (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:ROSA
Middle Name:
Last Name:COPPOLECCHIA
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BAYER BLVD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1544
Mailing Address - Country:US
Mailing Address - Phone:862-404-4984
Mailing Address - Fax:
Practice Address - Street 1:100 BAYER BLVD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1544
Practice Address - Country:US
Practice Address - Phone:862-404-4984
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMB05982900207R00000X
NY231063-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine