Provider Demographics
NPI:1962992008
Name:DEFILIPPO, EUNICE MODUPE MARTINS (MD)
Entity type:Individual
Prefix:
First Name:EUNICE
Middle Name:MODUPE MARTINS
Last Name:DEFILIPPO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:EUNICE
Other - Middle Name:MODUPE
Other - Last Name:MARTINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:125 PATERSON STREET
Mailing Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE SUITE 5100
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-3220
Mailing Address - Country:US
Mailing Address - Phone:732-235-6968
Mailing Address - Fax:
Practice Address - Street 1:125 PATERSON STREET
Practice Address - Street 2:DEPARTMENT OF INTERNAL MEDICINE SUITE 5100
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-3220
Practice Address - Country:US
Practice Address - Phone:732-235-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-15
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA11565000208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics