Provider Demographics
NPI:1306968805
Name:FELIPE, RONALD A (MD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:A
Last Name:FELIPE
Suffix:
Gender:M
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:PO BOX 1305
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-0875
Mailing Address - Country:US
Mailing Address - Phone:215-579-1774
Mailing Address - Fax:215-504-4427
Practice Address - Street 1:446 BELLEVUE AVE
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4502
Practice Address - Country:US
Practice Address - Phone:215-579-1774
Practice Address - Fax:215-504-4427
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07612500207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2646726000OtherPABS
NJ202174618OtherHORIZON BC/BS NJ
NJ0021041Medicaid
NJ202174618OtherTAX ID
NJ1071807OtherAETNA
NJP00313560OtherRAIL ROAD MEDICARE
NJP00313560OtherRAIL ROAD MEDICARE
NJ1071807OtherAETNA