Provider Demographics
NPI:1881490753
Name:COPILOTIQ MEDICAL OF NEW JERSEY, PC
Entity type:Organization
Organization Name:COPILOTIQ MEDICAL OF NEW JERSEY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-380-4003
Mailing Address - Street 1:40 BURTON HILLS BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-5902
Mailing Address - Country:US
Mailing Address - Phone:615-993-5359
Mailing Address - Fax:
Practice Address - Street 1:40 BURTON HILLS BLVD STE 200
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37215-5902
Practice Address - Country:US
Practice Address - Phone:615-993-5359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COPILOTIQ, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care