MEDICARE: MRS. ANGELA THERESA MARINUCCI NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ00057800	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447276431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA THERESA MARINUCCI NP

Provider Business Mailing Address
First Line	:	414 HANCOCK DR
Second Line	:
City	:	MULLICA HILL
State	:	NJ
Zip	:	08062-1828
Country	:	US
Telephone Number	:	856-223-0908
Fax Number	:

Provider Business Practice Location Address
First Line	:	1527 FOREST GROVE RD
Second Line	:
City	:	VINELAND
State	:	NJ
Zip	:	08360-1865
Country	:	US
Telephone Number	:	856-697-7490
Fax Number	:	856-697-7494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	09/22/2010

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