Individual
DR. ANTHONY DELFICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
85 S MAPLE AVE, RIDGEWOOD, NJ 07450-4561
(201) 445-2830
(201) 445-7471
Mailing address
85 S MAPLE AVE, RIDGEWOOD, NJ 07450-4561
(201) 445-2830
(201) 445-7471
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
25MA05949400
NJ
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
25MA05949400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1039889
AETNA HMO ID #
NJ
01
—
200032948
RR MDCR #
NJ
01
—
5195618
AETNA PPO ID #
NJ
01
—
81G221
EMPIRE BC/BS OF NY ID #
NJ
01
—
P1094584
OXFORD ID #
NJ
Enumeration date
06/02/2005
Last updated
04/26/2019
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