Provider Demographics
NPI:1790898641
Name:COPPAGE, MYRA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:MYRA
Middle Name:L
Last Name:COPPAGE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
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Mailing Address - Street 1:UNIVERSITY OF ROCHESTER MC DEPT OF PATHOLOGY
Mailing Address - Street 2:601 ELMWOOD AVE BOX 608
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-0985
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF ROCHESTER MC DEPT OF PATHOLOGY
Practice Address - Street 2:601 ELMWOOD AVE BOX 608
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-0985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist