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General NPI Number Information
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NPI Number | 1225036874
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Entity Type | Individual
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Provider Name | ROCCO JOSEPH DIMATTIA III RPH
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Gender | Male
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Dates
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Enumeration Date | 07/08/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1300 S 18TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19146-4601
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Country | US
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Telephone | 215-468-1202
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Fax | 215-551-4068
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Provider Business Mailing Address
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Address Line | 6 SUNSET DR
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City | VOORHEES
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State | NJ
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Zip | 08043-4928
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Country | US
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Telephone | 215-468-1202
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Fax | 215-551-0468
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP040162L
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License Number State | PA
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