Provider Demographics
NPI:1407897812
Name:JAMES R. FILIPPO, OD
Entity Type:Organization
Organization Name:JAMES R. FILIPPO, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:GERI
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-335-9090
Mailing Address - Street 1:2614 RHAWN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19152-3415
Mailing Address - Country:US
Mailing Address - Phone:215-335-9090
Mailing Address - Fax:215-333-5225
Practice Address - Street 1:2614 RHAWN ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19152-3415
Practice Address - Country:US
Practice Address - Phone:215-335-9090
Practice Address - Fax:215-333-5225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001388152W00000X, 152WP0200X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No152WP0200XEye and Vision Services ProvidersOptometristPediatricsGroup - Single Specialty
No152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU06321Medicare UPIN
PAFI287196Medicare ID - Type UnspecifiedMEDICARE ACCOUNT #
PA0266930001Medicare NSC