Healthcare Provider Details

I. General information

NPI: 1700033818
Provider Name (Legal Business Name): KADIJA KALLON FILIMON FNP - BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KADIJA FILIMON RN

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 01/01/2025
Certification Date: 01/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 KENMORE RD
FREEHOLD NJ
07728-7851
US

IV. Provider business mailing address

6 KENMORE RD
FREEHOLD NJ
07728-7851
US

V. Phone/Fax

Practice location:
  • Phone: 347-628-3683
  • Fax:
Mailing address:
  • Phone: 347-628-3683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NR20023400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2626566
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NR20023400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: