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| Type | Legal entity | [sources] | |||
|---|---|---|---|---|---|
| Name | COPPOLA, KELLY AKA | [sources] | |||
| Legal form | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| Sector | PHARM | [sources] | |||
| Status | not available | [sources] | |||
| Address | 52 CORNELL DRIVE, HAZLET, NJ 07730 | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
us-mednj-d7a43b195d35015f1be0d73fc82c971b0f47a1b4 · us-mednj-b1f6df54a07a4050c5230976e6126d3145150193For experts: raw data explorer
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | New Jersey Office of the State Comptroller | - | |||
| Address | ||
|---|---|---|
| Full address | Country | |
| 52 CORNELL DRIVE, HAZLET, NJ 07730 | United States of America | |