Healthcare Provider Details

I. General information

NPI: 1811182215
Provider Name (Legal Business Name): ROCCO CAVALIERI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2007
Last Update Date: 09/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 E BROAD ST
BRIDGETON NJ
08302-2831
US

IV. Provider business mailing address

52 E BROAD ST
BRIDGETON NJ
08302-2831
US

V. Phone/Fax

Practice location:
  • Phone: 856-455-0777
  • Fax: 856-455-6896
Mailing address:
  • Phone: 856-455-0777
  • Fax: 856-455-6896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02293300
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP034080L
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberA1-0003023
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: