Provider Demographics
NPI:1962245944
Name:CICITTA, JOSEPH A (RPH)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:A
Last Name:CICITTA
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 1:2 CODINGTON LN
Mailing Address - Street 2:
Mailing Address - City:GLEN GARDNER
Mailing Address - State:NJ
Mailing Address - Zip Code:08826-3508
Mailing Address - Country:US
Mailing Address - Phone:908-500-9671
Mailing Address - Fax:
Practice Address - Street 1:4 STEWART CT
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-1028
Practice Address - Country:US
Practice Address - Phone:973-513-9031
Practice Address - Fax:973-513-9032
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02145600183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist