Cooper Family Medicine PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COOPER FAMILY MEDICINE PC

Practice address

200 College Drive
Blackwood, NJ 08012-3228

Phone

(856) 536-1630

Fax

(856) 536-1635

NPI assigned

Apr 4, 2016

Organization subpart

Yes

Parent organization

COOPER FAMILY MEDICINE PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Anthony Mazzarelli, M.D.

Title

Cmo

Phone

(856) 968-7858

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Robert Senese MD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1459728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459728000000",
    "number": "1508229790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL STREET",
            "address_2": "SUITE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4920",
            "fax_number": "856-382-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 COLLEGE DRIVE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "080123228",
            "telephone_number": "856-536-1630",
            "fax_number": "856-536-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER FAMILY MEDICINE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COOPER FAMILY MEDICINE PC",
        "enumeration_date": "2016-04-04",
        "last_updated": "2016-04-04",
        "status": "A",
        "authorized_official_last_name": "MAZZARELLI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "856-968-7858",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Family Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.