Provider Demographics
NPI:1689080509
Name:CORTELLESSA, ANTHONY (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:CORTELLESSA
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 PINE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-2816
Mailing Address - Country:US
Mailing Address - Phone:856-427-6923
Mailing Address - Fax:
Practice Address - Street 1:3400 NEW JERSEY AVE
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08260-6116
Practice Address - Country:US
Practice Address - Phone:609-729-0162
Practice Address - Fax:609-729-4682
Is Sole Proprietor?:No
Enumeration Date:2014-07-11
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03529700183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist