Healthcare Provider Details

I. General information

NPI: 1356151633
Provider Name (Legal Business Name): JILLIAN G CAPRIO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 01/09/2025
Certification Date: 01/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

875 KINGS HWY STE 100
WEST DEPTFORD NJ
08096-3165
US

IV. Provider business mailing address

257 PAVONIA CIRCLE
MARLTON NJ
08053
US

V. Phone/Fax

Practice location:
  • Phone: 856-251-0500
  • Fax:
Mailing address:
  • Phone: 856-281-4941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL06116400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: