Provider Demographics
NPI:1588741870
Name:TOCCO, JOHN RAYMOND (DPT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:RAYMOND
Last Name:TOCCO
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:306 W SOMERDALE RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-2237
Mailing Address - Country:US
Mailing Address - Phone:856-504-3150
Mailing Address - Fax:856-504-3157
Practice Address - Street 1:701 W. SOMERDALE ROAD
Practice Address - Street 2:
Practice Address - City:SOMERDALE
Practice Address - State:NJ
Practice Address - Zip Code:08083
Practice Address - Country:US
Practice Address - Phone:856-504-3150
Practice Address - Fax:856-504-3157
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
NJ40QA01223500174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist