Provider Demographics
NPI:1326038480
Name:VIZZI, VERONICA (RPH, CCP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:VIZZI
Suffix:
Gender:F
Credentials:RPH, CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 MATRO AVE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-9659
Mailing Address - Country:US
Mailing Address - Phone:856-795-3131
Mailing Address - Fax:856-672-0347
Practice Address - Street 1:1667 E LANDIS AVE
Practice Address - Street 2:BUILDING C
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-2942
Practice Address - Country:US
Practice Address - Phone:856-794-5380
Practice Address - Fax:877-309-3043
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-28
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RIO1644200183500000X
DEA10003056183500000X
PARP044641R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist