Provider Demographics
NPI:1376825976
Name:DUCCI, ROBERTA (RPH)
Entity Type:Individual
Prefix:MISS
First Name:ROBERTA
Middle Name:
Last Name:DUCCI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DALEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-3402
Mailing Address - Country:US
Mailing Address - Phone:973-473-3475
Mailing Address - Fax:
Practice Address - Street 1:20 DALEWOOD RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3402
Practice Address - Country:US
Practice Address - Phone:973-473-3475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01857300183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist