MEDICARE: RICHARD E FILIPEK DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213EP1101X	Primary Podiatric Medicine Podiatrist	25MD00204300	NJ

General Provider Information

NPI Number	:	1053589895
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RICHARD E FILIPEK DPM

Provider Business Mailing Address
First Line	:	486 VAN BUSSUM AVE
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-2060
Country	:	US
Telephone Number	:	973-546-1200
Fax Number	:	973-546-1819

Provider Business Practice Location Address
First Line	:	486 VAN BUSSUM AVE
Second Line	:
City	:	GARFIELD
State	:	NJ
Zip	:	07026-2060
Country	:	US
Telephone Number	:	973-546-1200
Fax Number	:	973-546-1819

Authorized Official
Title or Position	:	OWNER
Name	:	RICHARD E FILIPEK
Credential	:	DPM
Telephone Number	:	973-546-1200

Provider Enumeration Date	:	02/14/2008
Last Update Date	:	01/18/2009

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