Provider Demographics
NPI:1699745901
Name:PICCOLI, CATHERINE W (MD)
Entity type:Individual
Prefix:MS
First Name:CATHERINE
Middle Name:W
Last Name:PICCOLI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7710
Mailing Address - Country:US
Mailing Address - Phone:856-770-0504
Mailing Address - Fax:856-770-0395
Practice Address - Street 1:125 METRO CENTER BLVD STE 2000
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1785
Practice Address - Country:US
Practice Address - Phone:401-921-9202
Practice Address - Fax:401-921-9212
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA2921132085R0202X
NJ25MA065243002085R0202X
RIMD182432085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
60020208OtherHORIZON NJ HEALTH
NJ6379206Medicaid
1202272OtherAETNA
263267400OtherAMERIHEALTH
P00323693OtherRAILROAD MEDICARE
1396272OtherUNITED HEALTH
A3738029OtherOXFORD HEALTH
PI1795884OtherHIGHMARK PA BLUE SHIELD
1989801OtherFIRST HEALTH
1396272OtherUNITED HEALTH
E52847Medicare UPIN