Bert Anthony Coppotelli, MD is a
Family Medicine physician based in Lisbon, Connecticut. Bert Anthony Coppotelli is licensed to practice in Connecticut (license number 26684) and his current practice location is 2 Lee Rd, Lisbon, Connecticut. He can be reached at his office (for appointments etc.) via phone at
(860) 376-4451.
NPI number for Bert Anthony Coppotelli is 1629070941 and his current mailing address is 2 Lee Rd, Lisbon, Connecticut. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1629070941.
Physician's Profile
| Full Name | Bert Anthony Coppotelli |
|---|
| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 2 Lee Rd, Lisbon, Connecticut |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1629070941
- Provider Enumeration Date: 06/01/2005
- Last Update Date: 09/05/2007
Medical Identifiers
Medical identifiers for Bert Anthony Coppotelli such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629070941 | NPI | - | NPPES |
| 010621809 | Other | | TID# |
| 010621809 | Other | | UNHC |
| 2V1389 | Other | | HEALTHNET |
| 00126684004 | Other | | BCBS |
| 001266840 | Medicaid | CT | |
| 010621809 | Other | | CIGNA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 26684 (Connecticut) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Bert Anthony Coppotelli is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Bert Anthony Coppotelli, MD
2 Lee Rd,
Lisbon, CT 06351-3015
Ph: (860) 376-4451 | Bert Anthony Coppotelli, MD
2 Lee Rd,
Lisbon, CT 06351-3015
Ph: (860) 376-4451 |
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