Provider Demographics
NPI:1710063797
Name:FILIPPONE, MARK AP (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:AP
Last Name:FILIPPONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2012 KENNEDY BLVD.
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07305
Mailing Address - Country:US
Mailing Address - Phone:201-435-2834
Mailing Address - Fax:201-435-2927
Practice Address - Street 1:15 MORRISSEE AVE
Practice Address - Street 2:
Practice Address - City:WALLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07057
Practice Address - Country:US
Practice Address - Phone:201-528-7851
Practice Address - Fax:201-528-7853
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2018-08-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA03158000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC54995Medicare UPIN