Healthcare Provider Details

I. General information

NPI: 1477830396
Provider Name (Legal Business Name): MR. GERALD CIOCE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2011
Last Update Date: 11/06/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 VALLEY RD
CLIFTON NJ
07013-1319
US

IV. Provider business mailing address

377 VALLEY RD
CLIFTON NJ
07013-1319
US

V. Phone/Fax

Practice location:
  • Phone: 973-278-8876
  • Fax: 973-279-3059
Mailing address:
  • Phone: 973-278-8876
  • Fax: 973-279-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI01358200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: