MEDICARE: MR. JOSEPH PUCCI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	28RI01791600	NJ

General Provider Information

NPI Number	:	1134240609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH PUCCI RPH

Provider Business Mailing Address
First Line	:	501 LITTLE SILVER POINT RD
Second Line	:
City	:	LITTLE SILVER
State	:	NJ
Zip	:	07739-1768
Country	:	US
Telephone Number	:	732-859-4994
Fax Number	:

Provider Business Practice Location Address
First Line	:	501 LITTLE SILVER POINT RD
Second Line	:
City	:	LITTLE SILVER
State	:	NJ
Zip	:	07739-1768
Country	:	US
Telephone Number	:	732-859-4994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	07/08/2007

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