Healthcare Provider Details

I. General information

NPI: 1396736583
Provider Name (Legal Business Name): VINCENT DE FILIPPI, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MAIN ST
PATERSON NJ
07503-2621
US

IV. Provider business mailing address

703 MAIN ST
PATERSON NJ
07503-2621
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-2486
  • Fax: 973-754-2475
Mailing address:
  • Phone: 973-754-2486
  • Fax: 973-754-2475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: BRIDGET CHAMPINO
Title or Position: OFFICE MANAGER
Credential:
Phone: 201-635-1003