Individual
MR. JOHN A MUCCITELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
1930 S BROAD ST, UNIT 3, PHILADELPHIA, PA 19145-2328
(215) 339-4747
Mailing address
324 S 11TH ST APT 31, PHILADELPHIA, PA 19107-6054
(215) 512-2520
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN517275L
PA
163W00000X
Registered Nurse
RN9281549
FL
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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