Provider Demographics
NPI:1477830396
Name:CIOCE, GERALD
Entity Type:Individual
Prefix:MR
First Name:GERALD
Middle Name:
Last Name:CIOCE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:377 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-1319
Mailing Address - Country:US
Mailing Address - Phone:973-278-8876
Mailing Address - Fax:973-279-3059
Practice Address - Street 1:377 VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-1319
Practice Address - Country:US
Practice Address - Phone:973-278-8876
Practice Address - Fax:973-279-3059
Is Sole Proprietor?:No
Enumeration Date:2011-11-06
Last Update Date:2011-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01358200183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist