Cooper Family Medicine, Pc | |
1050 Kings Hwy N Suite 105 Cherry Hill NJ 08034-1909 | |
(856) 321-0303 | |
(856) 321-0090 |
Full Name | Cooper Family Medicine, Pc |
---|---|
Speciality | Family Medicine |
Location | 1050 Kings Hwy N, Cherry Hill, New Jersey |
Authorized Official Name and Position | Anthony J. Mazzarelli (CHIEF MEDICAL OFFICE) |
Authorized Official Contact | 8569687858 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Cooper Family Medicine, Pc 1 Federal Street Sw-200 Camden NJ 08103-1155 Ph: (856) 356-4924 | Cooper Family Medicine, Pc 1050 Kings Hwy N Suite 105 Cherry Hill NJ 08034-1909 Ph: (856) 321-0303 |
NPI Number | 1649217175 |
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Provider Enumeration Date | 06/01/2006 |
Last Update Date | 07/27/2016 |
Medicare PECOS PAC ID | 4284530197 |
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Medicare Enrollment ID | O20040224000014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649217175 | NPI | - | NPPES |
6558101 | Medicaid | NJ | |
812711 | Other | AETNA | |
957013 | Other | AETNA | |
0341834001 | Other | AMERIHEALTH | |
10825 | Other | AETNA | |
0538689001 | Other | AMERIHEALTH | |
0790979001 | Other | AMERIHEALTH | |
10678 | Other | AETNA | |
0807068001 | Other | AMERIHEALTH | |
0125591001 | Other | AMERIHEALTH | |
0807062001 | Other | AMERIHEALTH | |
10665 | Other | AETNA | |
2218882006 | Other | AMERIHEALTH | |
497006 | Other | AETNA | |
511584 | Other | AETNA | |
0807066001 | Other | AMERIHEALTH | |
10453 | Other | AETNA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (New Jersey) | Primary |
Provider Name | Lara A Bruneau |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1669410445 PECOS PAC ID: 7719889195 Enrollment ID: I20040126000288 |
Provider Name | Mary Willard |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1336138007 PECOS PAC ID: 1850387135 Enrollment ID: I20040422000419 |
Provider Name | Darryl B Floyd |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1689676421 PECOS PAC ID: 1759371750 Enrollment ID: I20040513000083 |
Provider Name | Catherine Ann Barone |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1568676989 PECOS PAC ID: 6608808282 Enrollment ID: I20051012000245 |
Provider Name | Edmund J Decker |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1851308779 PECOS PAC ID: 0749209922 Enrollment ID: I20051116000896 |
Provider Name | Daniel J Hyman |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1346335023 PECOS PAC ID: 2769405273 Enrollment ID: I20060111000356 |
Provider Name | Nirandra Mahamitra |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669663217 PECOS PAC ID: 1850485236 Enrollment ID: I20070920000781 |
Provider Name | Kennedy U Ganti |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1235322165 PECOS PAC ID: 0547356149 Enrollment ID: I20071012000043 |
Provider Name | Dyanne Westerberg |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1215911987 PECOS PAC ID: 4183712318 Enrollment ID: I20071121000250 |
Provider Name | Stephen E Paul |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1629075759 PECOS PAC ID: 4789679408 Enrollment ID: I20080805000276 |
Provider Name | Danielle S Nordone |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699765354 PECOS PAC ID: 6204859481 Enrollment ID: I20080819000118 |
Provider Name | Adaliz Rivera |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508073362 PECOS PAC ID: 7719053834 Enrollment ID: I20080913000007 |
Provider Name | Marie Edwige Louis |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1265472484 PECOS PAC ID: 8426021742 Enrollment ID: I20081103000610 |
Provider Name | Sangita K Doshi |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376505057 PECOS PAC ID: 1355390519 Enrollment ID: I20090102000289 |
Provider Name | Laurie L Weinberg |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1104018431 PECOS PAC ID: 9537224704 Enrollment ID: I20090223000450 |
Provider Name | Jessica E Horvath-matthews |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1740357953 PECOS PAC ID: 6709986862 Enrollment ID: I20090602000238 |
Provider Name | Stephanie M Tonetta-stanker |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588735963 PECOS PAC ID: 3678627619 Enrollment ID: I20090811000130 |
Provider Name | Michael J Voyack |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1003896028 PECOS PAC ID: 0749336634 Enrollment ID: I20090917000388 |
Provider Name | Tracey L Brobyn |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1437230901 PECOS PAC ID: 7810031788 Enrollment ID: I20100216000145 |
Provider Name | Kedron Nicole Horvath |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1346450723 PECOS PAC ID: 3870780844 Enrollment ID: I20101203000505 |
Provider Name | Peter Kelly |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982869467 PECOS PAC ID: 5092995688 Enrollment ID: I20110215000332 |
Provider Name | Esther Malave |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1992747885 PECOS PAC ID: 3375514748 Enrollment ID: I20111107000712 |
Provider Name | Rachel N Adams |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1164707642 PECOS PAC ID: 6406021781 Enrollment ID: I20111215000098 |
Provider Name | Adolfo E Prettelt |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1205989241 PECOS PAC ID: 0749464527 Enrollment ID: I20120626000083 |
Provider Name | Sophia S Khan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417186842 PECOS PAC ID: 4284873126 Enrollment ID: I20130625000466 |
Provider Name | Nicole E Hancq |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1942400205 PECOS PAC ID: 3072652064 Enrollment ID: I20130717000125 |
Provider Name | Ivy Hampton |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316389018 PECOS PAC ID: 7113152034 Enrollment ID: I20131031001287 |
Provider Name | Wai B Chan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710291307 PECOS PAC ID: 7618108234 Enrollment ID: I20140325001261 |
Provider Name | Fern Elyse Kopp Mulberg |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1699077909 PECOS PAC ID: 8628206075 Enrollment ID: I20140904000975 |
Provider Name | Camille Henry |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1093865115 PECOS PAC ID: 8426172644 Enrollment ID: I20150204001131 |
Provider Name | Heather C Wilmore |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194123133 PECOS PAC ID: 4981920626 Enrollment ID: I20150224001112 |
Provider Name | Allen Clowers |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1386624427 PECOS PAC ID: 0941309256 Enrollment ID: I20160111000154 |
Provider Name | Kristin Hextall |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790147304 PECOS PAC ID: 1850690348 Enrollment ID: I20160505000051 |
Provider Name | Sarah A Abdelsayed |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1093065138 PECOS PAC ID: 9032346622 Enrollment ID: I20160929000105 |
Provider Name | Jennifer Abraczinskas |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1770921033 PECOS PAC ID: 0840581211 Enrollment ID: I20161027002374 |
Provider Name | Rosanna Eang |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1366857997 PECOS PAC ID: 0446537658 Enrollment ID: I20170425002358 |
Provider Name | Alycia Anne Trossen |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710249891 PECOS PAC ID: 4385957794 Enrollment ID: I20170606002900 |
Provider Name | Navjot Singh Narula |
---|---|
Provider Type | Practitioner - Hospitalist |
Provider Identifiers | NPI Number: 1578947230 PECOS PAC ID: 4789932914 Enrollment ID: I20180806000141 |
Provider Name | Sarah Elizabeth Green |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1497246284 PECOS PAC ID: 9436409166 Enrollment ID: I20180830000962 |
Provider Name | Michelle L Henritzy |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1376002444 PECOS PAC ID: 0547503534 Enrollment ID: I20190514002445 |
Provider Name | Mara H Gordon |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1730575630 PECOS PAC ID: 6406107259 Enrollment ID: I20190912002122 |
Provider Name | Emily Myhre |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1659746196 PECOS PAC ID: 0941600787 Enrollment ID: I20210615003028 |
Provider Name | Lori Atkinson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1417375478 PECOS PAC ID: 9234353350 Enrollment ID: I20230217001933 |
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