Provider Demographics
NPI:1285741454
Name:CIPPARONE, STEVEN ANTHONY (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:CIPPARONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 PREAKNESS DR
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-3603
Mailing Address - Country:US
Mailing Address - Phone:856-906-6079
Mailing Address - Fax:856-629-4261
Practice Address - Street 1:3501 ROUTE 42
Practice Address - Street 2:
Practice Address - City:TURNERSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08012-1752
Practice Address - Country:US
Practice Address - Phone:856-629-4207
Practice Address - Fax:856-629-4261
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJOA005489152W00000X
PAOEG000338152W00000X
NJTO00919152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ14014OtherSPECTERA
PA397536OtherNVA
NJ2638937OtherAETNA
NJ118218OtherEYEMED
PA2637159OtherAETNA
NJ311368OtherNVA
NJ378344OtherBC/BS
PA1338709OtherBC/BS
NJ8997403Medicaid
NJ311368OtherNVA
NJ14014OtherSPECTERA