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NPI Code Detail

MEDICARE: DR. ANTHONY DELFICO M.D.

MEDICARE:  DR. ANTHONY  DELFICO  M.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
1207X00000XOrthopaedic Surgery Physician25MA05949400NJ
2207XX0005XSports Medicine (Orthopaedic Surgery) Physician25MA05949400NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P1094584OTHERNJOXFORD ID #
21039889OTHERNJAETNA HMO ID #
3200032948OTHERNJRR MDCR #
481G221OTHERNJEMPIRE BC/BS OF NY ID #
55195618OTHERNJAETNA PPO ID #

General Provider Information

NPI Number : 1275535379
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY DELFICO M.D.
Provider Business Mailing Address
First Line : 85 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4561
Country : US
Telephone Number : 201-445-2830
Fax Number : 201-445-7471
Provider Business Practice Location Address
First Line : 85 S MAPLE AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-4561
Country : US
Telephone Number : 201-445-2830
Fax Number : 201-445-7471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/02/2005
Last Update Date : 04/26/2019

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Directions to “ DR. ANTHONY DELFICO M.D.” Practice Location

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