VPC Medspa 1 LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Legal business name

VPC MEDSPA 1 LLC

Doing business as

Bare Aesthetic

Practice address

200 Closter Dock Rd FL 2
Closter, NJ 07624-1928

Phone

(201) 564-7521

NPI assigned

May 24, 2020

Last updated

May 24, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Vanessa Coppola, A.P.N.NPI 1881233666

Title

Owner

Phone

(201) 564-7521

Specialties & licenses 1

Addresses

Other names 1

• Bare Aesthetic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vanessa Coppola, APN

  • Nurse Practitioner
  • Closter, NJ
  • NPI 1881233666
  NPD Authorized official

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

{
    "created_epoch": "1590278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590278400000",
    "number": "1841813995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PARK ST STE 2058",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423443",
            "telephone_number": "201-564-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLOSTER DOCK RD FL 2",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076241928",
            "telephone_number": "201-564-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VPC MEDSPA 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-24",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A",
        "authorized_official_last_name": "COPPOLA",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-564-7521",
        "authorized_official_credential": "A.P.N."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bare Aesthetic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nurse Practitioner in Closter, NJ
• Providers in Closter, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.