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General NPI Number Information
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NPI Number | 1366537714
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Entity Type | Individual
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Provider Name | MICHELLE SOPHIA GIOVANNUCCI RPH
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 06/04/2019
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Provider Practice Location Address
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Address Line | 3031 RED LION RD
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City | PHILADELPHIA
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State | PA
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Zip | 19114-1123
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Country | US
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Telephone | 215-347-0727
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Fax |
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Provider Business Mailing Address
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Address Line | 54 DELLETT COURT
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City | SHAMONG
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State | NJ
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Zip | 08088-9511
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Country | US
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Telephone | 908-347-8411
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Fax | 609-268-7164
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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 | 28RI02175700
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License Number State | NJ
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