Provider Demographics
NPI:1548751449
Name:DEFILIPPO, DAVID JOSEPH
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JOSEPH
Last Name:DEFILIPPO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 RYDERS LN
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-1666
Mailing Address - Country:US
Mailing Address - Phone:203-381-9555
Mailing Address - Fax:203-380-9165
Practice Address - Street 1:88 RYDERS LN
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-1666
Practice Address - Country:US
Practice Address - Phone:203-381-9555
Practice Address - Fax:203-380-9165
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000319261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech