Healthcare Provider Details

I. General information

NPI: 1295944379
Provider Name (Legal Business Name): ALBERT J CELIDONIO RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 W LANCASTER AVE
PAOLI PA
19301-1763
US

IV. Provider business mailing address

115 STANFORD DRIVE
CHESTER SPRINGS PA
19425
US

V. Phone/Fax

Practice location:
  • Phone: 610-648-1173
  • Fax: 610-722-4997
Mailing address:
  • Phone: 610-648-1173
  • Fax: 610-722-4997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP038149L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: