COOPER UNIVERSITY TRAUMA PHYSICIANS, PC (NPI# 1790724730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790724730 |
| Entity Type | Organization |
| Organization Name | COOPER UNIVERSITY TRAUMA PHYSICIANS, PC |
| Practice Address |
1 Cooper Plz Camden NJ 08103-1461 |
| Mailing Address |
1 Federal Street Sw-200 Camden NJ 08103-1155 |
| Practice Telephone | 8563423014 |
| Practice Fax Number | 8563422817 |
| Mailing Telephone | 8563564924 |
| Mailing Fax Number | 8563826455 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2016-07-27 |
| Authorized Official Name | ANTHONY J. MAZZARELLI (CHIEF MEDICAL OFFICE) |
| Authorized Official Telephone | 8569687858 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0127X |
Surgery Specialization: Trauma Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
NJ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0060542 | 05 | |
| NJ | AMERIHEALTH/KEYSTONE/IBC | 2283236000 | 01 |
| NJ | AETNA GRP NUMBER | 3308828 | 01 |
| Street Address |
1 COOPER PLZ |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08103-1461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245230911 | Daniel Kwa | Acupuncturist | 1 Cooper Plz, Camden, NJ 08103-1461 | 2005-07-26 |
| 1053910927 | Shane Aldon Cooper | Nurse Practitioner | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-10-22 |
| 1396351722 | Christopher Alexander Rivera-pintado | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-09-21 |
| 1285252361 | Dhaval Dharmendra Rana | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-06 |
| 1891312195 | Vincent Verchio | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1861019036 | Calvin Ro | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1770100943 | Andrea Villa | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-02 |
| 1376160739 | Kristen Knapp | Student in an Organized Health Care Education/Training Program | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-07-01 |
| 1447874417 | Cassie Seto | Nurse Anesthetist, Certified Registered | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-06-04 |
| 1215551437 | Cooper Care Alliance, PC | Specialist | 1 Cooper Plz, Camden, NJ 08103-1461 | 2020-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516063 | Toni Marie Primas | Registered Nurse | Sheridan Pavilion, Three Cooper Plaza Suite 220, Camden, NJ 08103 | 2020-07-24 |
| 1376028548 | Services To Overcome Drug Abuse Among Teenagers, Inc. | Clinic/Center | 805-815 Federal Street, Camden, NJ 08103 | 2018-10-03 |
| 1942795802 | Kyle Richard Marden | Student in an Organized Health Care Education/Training Program | 401 Haddon Avenue, 2nd Floor Room 266, Camden, NJ 08103 | 2018-06-24 |
| 1588157473 | Julio Antonio Rodriguez Jr. | Student in an Organized Health Care Education/Training Program | Cooper University Hospital, 3 Cooper Plaza Suite 408, Camden, NJ 08103 | 2018-06-14 |
| 1386149748 | Shuchi Gupta | Nurse Practitioner | 519 West Street, Camden, NJ 08103 | 2018-03-28 |
| 1326541491 | Bolanle Idowu-akangbe | Nurse Practitioner | 519-525 West Street, Camden, NJ 08103 | 2018-03-14 |
| 1740709500 | New Beginnings Behavioral Health | Clinic/Center | 1300 Princess Avenue, Camden, NJ 08103 | 2017-09-13 |
| 1760905012 | Loraine Morris | Counselor | 1479 Kaighn Ave, Camden, NJ 08103 | 2017-07-19 |
| 1386164333 | Matthew Share | Genetic Counselor, MS | Two Cooper Plaza, 400 Haddon Avenue, Md Anderson Cancer Center, Camden, NJ 08103 | 2017-06-21 |
| 1568902070 | Cooper University Hospital | General Acute Care Hospital | 1 Cooper Plaza, Dorrance 222, Camden, NJ 08103 | 2017-03-02 |
| Find all providers in zip 08103 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477825891 | Tanya Egodage | Surgery | 1 Cooper Plz, Camden, NJ 08103-1461 | 2012-01-31 |
| 1679884431 | Anna Goldenberg | Surgery | 1 Cooper Plz, Camden, NJ 08103-1461 | 2010-06-27 |
| 1730264581 | Steven E Ross | Surgery | 1 Cooper Plz, Cooper Trauma Physicians, Camden, NJ 08103-1461 | 2006-10-26 |
| 1609973700 | Frank J Deangelo | Surgery | 1 Cooper Plz, Cooper University Trauma Physicians, Camden, NJ 08103-1461 | 2006-09-20 |
| 1295745966 | Geroge Tsiotsias | Surgery | 1 Cooper Plz, Cooper Univeristy Trauma Physicians, Camden, NJ 08103-1461 | 2006-08-08 |
| 1598727893 | Alberto Nunez | Surgery | 1 Cooper Plz, Camden, NJ 08103 | 2006-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609137348 | Christopher Alan Butts | Surgery | 125 Paterson St Ste 6300, New Brunswick, NJ 08901 | 2012-05-30 |
| 1265452221 | Bruno Molino | Surgery | Jersey City Medical Center, Dept. of Surgery, 355 Grand Street, Jersey City, NJ 07302 | 2006-07-20 |
| 1689606956 | Liberty Surgical Associates | Surgery | 377 Jersey Avenue, Suite 220, Jersey City, NJ 07302-4396 | 2006-07-07 |
| 1376572198 | Richard Edward Constable | Surgery | 655 Amboy Ave Ste C, Woodbridge, NJ 07095-3159 | 2006-07-02 |
| 1396799565 | Vincent Lavaughn Moss | Surgery | 98 James St 202, Edison, NJ 08820-3902 | 2006-05-20 |
| 1356730873 | Nikolas Sebastian Kappy | Surgery | 750 Brunswick Ave, Trenton, NJ 08638-4143 | 2015-01-21 |
| 1609215029 | Amanda Liane Teichman | Surgery | 125 Paterson St, New Brunswick, NJ 08901-1962 | 2013-06-19 |
| 1083907224 | Capital Health Surgical Group | Surgery | 40 Fuld St, Suite 303, Trenton, NJ 08638-5247 | 2011-05-20 |
| 1831422260 | Seung Hoon Shin | Surgery | 1945 State Route 33, Neptune, NJ 07753-4859 | 2009-09-17 |
| 1437385085 | Victor Vinh Ha | Surgery | 355 Grand St, Jersey City, NJ 07302-4321 | 2009-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.