Provider Demographics
NPI:1164588364
Name:DE FILIPPO, FLORA (PHD)
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:DE FILIPPO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HORSESHOE LN N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NJ
Mailing Address - Zip Code:08022-1056
Mailing Address - Country:US
Mailing Address - Phone:201-407-3153
Mailing Address - Fax:
Practice Address - Street 1:52 HORSESHOE LN N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NJ
Practice Address - Zip Code:08022-1056
Practice Address - Country:US
Practice Address - Phone:201-407-3153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3243103G00000X
NY012047-1103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist