Provider Demographics
NPI:1215905625
Name:FILIPPI, ALAN D (PHD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:D
Last Name:FILIPPI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:BERGENFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07621-1221
Mailing Address - Country:US
Mailing Address - Phone:201-417-7877
Mailing Address - Fax:201-501-0940
Practice Address - Street 1:136 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:BERGENFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07621-1221
Practice Address - Country:US
Practice Address - Phone:201-417-7877
Practice Address - Fax:201-501-0940
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2007-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013861103T00000X
NJ4025103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1955540Medicaid
NJ8909407Medicaid
NJ063219Medicare PIN
NY1955540Medicaid