MEDICARE: MITCHELL E LIPTON MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	132321	NY

General Provider Information

NPI Number	:	1528345980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITCHELL E LIPTON MD PC

Provider Business Mailing Address
First Line	:	3515 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4230
Country	:	US
Telephone Number	:	718-763-9000
Fax Number	:

Provider Business Practice Location Address
First Line	:	3515 QUENTIN RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-4230
Country	:	US
Telephone Number	:	718-763-9000
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MITCHELL E LIPTON
Credential	:	M.D.
Telephone Number	:	718-763-9000

Provider Enumeration Date	:	11/12/2011
Last Update Date	:	11/12/2011

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