Healthcare Provider Details

I. General information

NPI: 1306821509
Provider Name (Legal Business Name): RICHARD E FILIPEK DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 01/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 VAN BUSSUM AVE
GARFIELD NJ
07026-2060
US

IV. Provider business mailing address

486 VAN BUSSUM AVE
GARFIELD NJ
07026-2060
US

V. Phone/Fax

Practice location:
  • Phone: 973-546-1200
  • Fax: 973-546-1819
Mailing address:
  • Phone: 973-546-1200
  • Fax: 973-546-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00204300
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number25MD00204300
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number25MD00204300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: