Colucciello, Michael

Colucciello, Michael is an individual health care provider with primary practice located at 509 S Lenola Rd Ste 11A , Moorestown NJ 08057-1561. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Colucciello, Michael can be contacted via phone (856) 234-0258.

Contact Information

Primary practice address
509 S Lenola Rd Ste 11A Moorestown NJ 08057-1561
Phone: (856) 234-0258
Fax: (856) 727-9518
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 25MA06592100 New Jersey
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X MD041676L Pennsylvania

Profile Details

NPI number 1215934146
LBN Legal business name Colucciello, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Apr 12th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215934146 NPPES
New Jersey MEDICAID 7315902

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