Provider Demographics
NPI:1548448806
Name:DEFILIPPO, DAVID PAUL (PA-C)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:DEFILIPPO
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:731 HIGHWAY 35 STE G
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-4767
Mailing Address - Country:US
Mailing Address - Phone:732-455-8444
Mailing Address - Fax:
Practice Address - Street 1:731 HIGHWAY 35 STE G
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4767
Practice Address - Country:US
Practice Address - Phone:732-455-8444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-08
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA053278363AM0700X
NJ25P00681200363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical