Healthcare Provider Details

I. General information

NPI: 1073433108
Provider Name (Legal Business Name): WILHELMINA AMELIA DIFILIPPO LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CHESTNUT ST
RIDGEWOOD NJ
07450-2504
US

IV. Provider business mailing address

26 DEVOE PL
HAWTHORNE NJ
07506-1004
US

V. Phone/Fax

Practice location:
  • Phone: 201-444-3550
  • Fax:
Mailing address:
  • Phone: 973-271-1939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SL07462500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: