Provider Demographics
NPI:1215157649
Name:BUCCO, ROBERT BERNARD (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:BERNARD
Last Name:BUCCO
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 1:114 CRANBURY RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3810
Mailing Address - Country:US
Mailing Address - Phone:732-899-0085
Mailing Address - Fax:
Practice Address - Street 1:114 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3810
Practice Address - Country:US
Practice Address - Phone:732-899-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02613500183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist