Provider Demographics
NPI:1275066862
Name:CIPOLLONE, RICHARD C JR (RN)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:C
Last Name:CIPOLLONE
Suffix:JR
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 SUSIE CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-9368
Mailing Address - Country:US
Mailing Address - Phone:610-757-8611
Mailing Address - Fax:
Practice Address - Street 1:7 SUSIE CT
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-9368
Practice Address - Country:US
Practice Address - Phone:610-757-8611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-10
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEL1-0049806163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse