Provider Demographics
NPI:1366475162
Name:PHILIP DARRIGO MD PA
Entity Type:Organization
Organization Name:PHILIP DARRIGO MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:DARRIGO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-455-2040
Mailing Address - Street 1:105 MANHEIM AVE
Mailing Address - Street 2:STE 10
Mailing Address - City:BRIDGETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08302
Mailing Address - Country:US
Mailing Address - Phone:856-455-2040
Mailing Address - Fax:856-455-8584
Practice Address - Street 1:105 MANHEIM AVE
Practice Address - Street 2:STE 10
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302
Practice Address - Country:US
Practice Address - Phone:856-455-2040
Practice Address - Fax:856-455-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-08
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA02063500207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2621304Medicaid
NJP00070151OtherRAILROAD MEDICARE
NJP00070151OtherRAILROAD MEDICARE
NJC55985Medicare UPIN