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General NPI Number Information
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NPI Number | 1275562605
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Entity Type | Individual
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Provider Name | MR. VINCENT A MARONE
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 10/14/2008
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Provider Practice Location Address
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Address Line | 10 HIGH ST E
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City | GLASSBORO
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State | NJ
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Zip | 08028-2520
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Country | US
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Telephone | 856-881-5121
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Fax | 856-881-9552
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Provider Business Mailing Address
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Address Line | 92 PEBBLE LN
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City | BLACKWOOD
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State | NJ
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Zip | 08012-5577
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Country | US
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Telephone | 856-374-0510
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Fax |
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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 | 12537
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License Number State | NJ
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