MEDICARE: DR. ALAN D. FILIPPI PH.D.

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	103T00000X	Psychologist	013861	NY
2	103T00000X	Psychologist	4025	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215905625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALAN D. FILIPPI PH.D.

Provider Business Mailing Address
First Line	:	136 N PROSPECT AVE
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-1221
Country	:	US
Telephone Number	:	201-417-7877
Fax Number	:	201-501-0940

Provider Business Practice Location Address
First Line	:	136 N PROSPECT AVE
Second Line	:
City	:	BERGENFIELD
State	:	NJ
Zip	:	07621-1221
Country	:	US
Telephone Number	:	201-417-7877
Fax Number	:	201-501-0940

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2006
Last Update Date	:	10/31/2007

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