Provider Demographics
NPI:1235355579
Name:CAMPISI, LUCRECIA M
Entity Type:Individual
Prefix:MRS
First Name:LUCRECIA
Middle Name:M
Last Name:CAMPISI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1340
Mailing Address - Country:US
Mailing Address - Phone:732-851-5600
Mailing Address - Fax:732-605-1185
Practice Address - Street 1:11 TAYLOR ROAD
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746
Practice Address - Country:US
Practice Address - Phone:732-851-5600
Practice Address - Fax:732-605-1185
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI02283800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist