John Brian Cudlipp,OD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

OA04898 Issued in NJ

Legal business name

JOHN BRIAN CUDLIPP,OD

Practice address

681 S Broadway
Suite 1
Pennsville, NJ 08070-2637

Phone

(856) 935-3937

Fax

(856) 935-4445

NPI assigned

Dec 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Brian Cudlipp, O.D.

Title

Optometrist/Owner

Phone

(856) 935-3937

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1477898260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080700187",
            "telephone_number": "856-935-3937",
            "fax_number": "856-935-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 S BROADWAY",
            "address_2": "SUITE 1",
            "city": "PENNSVILLE",
            "state": "NJ",
            "postal_code": "080702637",
            "telephone_number": "856-935-3937",
            "fax_number": "856-935-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN BRIAN CUDLIPP,OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "CUDLIPP",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "BRIAN",
        "authorized_official_title_or_position": "OPTOMETRIST/OWNER",
        "authorized_official_telephone_number": "856-935-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NJ",
            "license": "OA04898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5570107",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.