Provider Demographics
NPI:1508838764
Name:FILLER, JOAN ALPERT (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:ALPERT
Last Name:FILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WHITE PARK RD
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-2258
Mailing Address - Country:US
Mailing Address - Phone:607-257-3349
Mailing Address - Fax:
Practice Address - Street 1:111 WHITE PARK RD
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-2258
Practice Address - Country:US
Practice Address - Phone:607-257-3349
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2036612084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry