Healthcare Provider Details
I. General information
NPI: 1265299242
Provider Name (Legal Business Name): MRS. KATHERINE MAE FILIPPINI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 03/05/2024
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1268 ROUTE 37 W STE 1
TOMS RIVER NJ
08755-4999
US
IV. Provider business mailing address
79 GREENWOOD LOOP RD
BRICK NJ
08724-1262
US
V. Phone/Fax
- Phone: 732-602-4480
- Fax: 609-817-3276
- Phone: 201-920-6348
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 26NJ15023000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: