Provider Demographics
NPI:1548543614
Name:CHECCA, JUDITH MARIE (RPH)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:MARIE
Last Name:CHECCA
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-9670
Mailing Address - Country:US
Mailing Address - Phone:856-478-0280
Mailing Address - Fax:
Practice Address - Street 1:221 DELSEA DR N
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-2011
Practice Address - Country:US
Practice Address - Phone:856-881-5945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-24
Last Update Date:2011-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02240500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist