Basic Information
Provider Information
NPI: 1194399345
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZOPPINA
FirstName: NICHOLAS
MiddleName: PAUL
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 224 STRAWBRIDGE DR STE 100
Address2:  
City: MOORESTOWN
State: NJ
PostalCode: 080574602
CountryCode: US
TelephoneNumber: 8566774000
FaxNumber: 8562343014
Practice Location
Address1: 1 ROSSMOOR DR STE 101
Address2:  
City: MONROE TOWNSHIP
State: NJ
PostalCode: 088311596
CountryCode: US
TelephoneNumber: 6098609913
FaxNumber: 6098609915
Other Information
ProviderEnumerationDate: 05/13/2021
LastUpdateDate: 05/13/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/13/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X40QA01967500NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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