Provider Demographics
NPI:1275592065
Name:DEFELIPPO, NOEL P (MD)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:P
Last Name:DEFELIPPO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:400 HIGHLAND AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-7003
Mailing Address - Country:US
Mailing Address - Phone:978-741-4133
Mailing Address - Fax:978-741-7742
Practice Address - Street 1:400 HIGHLAND AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-7003
Practice Address - Country:US
Practice Address - Phone:978-741-4133
Practice Address - Fax:978-741-7742
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-06-17
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Provider Licenses
StateLicense IDTaxonomies
MA52182208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3002101Medicaid
MA3002101Medicaid
MAJ04838Medicare ID - Type Unspecified
MAA458074Medicare UPIN