Healthcare Provider Details

I. General information

NPI: 1821243379
Provider Name (Legal Business Name): REBEKAH ANN LIPSTEIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 PELHAM PKWY S 8N29 BLDG 1
BRONX NY
10461-1138
US

IV. Provider business mailing address

600 W 246TH ST APT 407
BRONX NY
10471-3611
US

V. Phone/Fax

Practice location:
  • Phone: 718-918-6981
  • Fax:
Mailing address:
  • Phone: 347-427-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number250707
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: