Provider Demographics
NPI:1053302257
Name:DE FILIPPI, VINCENT J (MD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:J
Last Name:DE FILIPPI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 SAN JOSE ST
Mailing Address - Street 2:301
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3928
Mailing Address - Country:US
Mailing Address - Phone:831-759-3289
Mailing Address - Fax:831-753-5188
Practice Address - Street 1:212 SAN JOSE ST
Practice Address - Street 2:301
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3928
Practice Address - Country:US
Practice Address - Phone:831-759-3289
Practice Address - Fax:831-753-5188
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA64383174400000X
CAG88362208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7001801Medicaid
NJG28646Medicare UPIN
NJ875343Medicare ID - Type Unspecified