Basic Information
| Provider Information | |||||||||
| NPI: | 1699963462 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CIPPARONE | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | ANTHONY | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 700 SECOND ST | ||||||||
| Address2: | STE E | ||||||||
| City: | SWEDESBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08085 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8562412222 | ||||||||
| FaxNumber: | 8562417961 | ||||||||
| Practice Location | |||||||||
| Address1: | 502-503 INDEPENDENCE BLVD | ||||||||
| Address2: | LAKESIDE BUSINESS PARK | ||||||||
| City: | SICKLERVILLE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 08081 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566298777 | ||||||||
| FaxNumber: | 8566298771 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2007 | ||||||||
| LastUpdateDate: | 10/05/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | MPT40QA01092600 | NJ | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.