Provider Demographics
NPI:1265003974
Name:COPPOLA, CINZIA G (CPNP)
Entity type:Individual
Prefix:MRS
First Name:CINZIA
Middle Name:G
Last Name:COPPOLA
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 GROVE ST
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02155-1448
Mailing Address - Country:US
Mailing Address - Phone:781-443-5625
Mailing Address - Fax:
Practice Address - Street 1:56 GROVE ST
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-1448
Practice Address - Country:US
Practice Address - Phone:781-443-5625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-03
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2322440163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics