Provider Demographics
NPI:1730388927
Name:PICCOLI, JOSEPH VINCENT (RPH)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:VINCENT
Last Name:PICCOLI
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 STRATFORD AVE
Mailing Address - Street 2:
Mailing Address - City:HADDON TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2327
Mailing Address - Country:US
Mailing Address - Phone:856-858-4040
Mailing Address - Fax:856-858-2313
Practice Address - Street 1:237 STRATFORD AVE
Practice Address - Street 2:
Practice Address - City:HADDON TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08108-2327
Practice Address - Country:US
Practice Address - Phone:856-858-4040
Practice Address - Fax:856-858-2313
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP033995R1835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric