| NPI | 1487252581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHU COPPOLA Pa 315-289-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2020-10-12 |
| Last Update Date | 2022-05-16 |