Healthcare Provider Details

I. General information

NPI: 1427398080
Provider Name (Legal Business Name): WANDA NOCELLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 ROUTE 70 E STE B
CHERRY HILL NJ
08034-2408
US

IV. Provider business mailing address

301 LIPPINCOTT DR STE 410
MARLTON NJ
08053-4197
US

V. Phone/Fax

Practice location:
  • Phone: 856-375-6240
  • Fax: 856-375-6241
Mailing address:
  • Phone: 856-355-0340
  • Fax: 856-355-0330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00416500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: