Individual provider Active NPI

Vincent Ciccotelli, RPH

  • Pharmacist
  • Mount Laurel, NJ
National Provider Identifier
1861878209
Registry record updated Aug 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI03716900 Issued in NJ
Practice address
3046 Route 38
Mount Laurel, NJ 08054-9723
Phone
(856) 727-1299
Fax
(856) 727-1754
NPI assigned
Aug 8, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI03716900 NJ Primary

Addresses

Primary practice location

3046 Route 38
Mount Laurel, NJ 08054-9723

Mailing address

150 E Partridge LN
Cherry Hill, NJ 08003-4408

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
28RI03716900NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1438992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438992000000",
    "number": "1861878209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E PARTRIDGE LN",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080034408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 ROUTE 38",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080549723",
            "telephone_number": "856-727-1299",
            "fax_number": "856-727-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICCOTELLI",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-08",
        "last_updated": "2015-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI03716900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; 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.