Provider Demographics
NPI:1922552306
Name:COPPOLA, HANNAH (DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:
Last Name:COPPOLA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:WEINREB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 CREDIT UNION WAY
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4633
Mailing Address - Country:US
Mailing Address - Phone:781-961-3370
Mailing Address - Fax:781-961-1291
Practice Address - Street 1:99 DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:MALDEN
Practice Address - State:MA
Practice Address - Zip Code:02148-5103
Practice Address - Country:US
Practice Address - Phone:781-605-1225
Practice Address - Fax:781-605-3451
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22405225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist