=====================================================
General NPI Number Information
=====================================================
NPI Number | 1174520738
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID JOHN FILTRANTI PA
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/28/2005
-----------------------------------------------------
Last Update Date | 11/09/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6 SAND HILL RD STE 102
-----------------------------------------------------
City | FLEMINGTON
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08822-4946
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-782-0600
-----------------------------------------------------
Fax | 908-782-7575
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1203 LANGHORNE NEWTOWN RD STE 138
-----------------------------------------------------
City | LANGHORNE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19047-1212
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-782-0600
-----------------------------------------------------
Fax | 908-782-7575
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363AS0400X
-----------------------------------------------------
Taxonomy Name | Surgical Physician Assistant
-----------------------------------------------------
License Number | 25MP00127600
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------