1306968805 NPI number — RONALD A FELIPE MD

Table of content: RONALD A FELIPE MD (NPI 1306968805)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306968805 NPI number — RONALD A FELIPE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELIPE
Provider First Name:
RONALD
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306968805
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1305
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18940-0875
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-579-1774
Provider Business Mailing Address Fax Number:
215-504-4427

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
446 BELLEVUE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08618-4502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-579-1774
Provider Business Practice Location Address Fax Number:
215-504-4427
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  25MA07612500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2646726000 . This is a "PABS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 202174618 . This is a "HORIZON BC/BS NJ" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0021041 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 202174618 . This is a "TAX ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1071807 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P00313560 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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