Healthcare Provider Details

I. General information

NPI: 1730388927
Provider Name (Legal Business Name): JOSEPH VINCENT PICCOLI RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2007
Last Update Date: 07/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

237 STRATFORD AVE
HADDON TOWNSHIP NJ
08108-2327
US

IV. Provider business mailing address

237 STRATFORD AVE
HADDON TOWNSHIP NJ
08108-2327
US

V. Phone/Fax

Practice location:
  • Phone: 856-858-4040
  • Fax: 856-858-2313
Mailing address:
  • Phone: 856-858-4040
  • Fax: 856-858-2313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License NumberRP033995R
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: