Provider Demographics
NPI:1023444692
Name:BOCCO, JAMES LAWRENCE JR (PHARM D, RPH)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LAWRENCE
Last Name:BOCCO
Suffix:JR
Gender:M
Credentials:PHARM D, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 ROUTE 73 S
Mailing Address - Street 2:
Mailing Address - City:EVESHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-2048
Mailing Address - Country:US
Mailing Address - Phone:856-988-6164
Mailing Address - Fax:
Practice Address - Street 1:404 ROUTE 73 S
Practice Address - Street 2:
Practice Address - City:EVESHAM
Practice Address - State:NJ
Practice Address - Zip Code:08053-2048
Practice Address - Country:US
Practice Address - Phone:856-988-6164
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03590900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist