Healthcare Provider Details

I. General information

NPI: 1205871704
Provider Name (Legal Business Name): MICHAEL S LIPPE MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 LAFAYETTE AVE
SUFFERN NY
10901-4817
US

IV. Provider business mailing address

100 ROUTE 59 STE 103A
SUFFERN NY
10901-4927
US

V. Phone/Fax

Practice location:
  • Phone: 845-368-4800
  • Fax: 845-369-1697
Mailing address:
  • Phone: 845-368-4800
  • Fax: 845-369-1697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146D00000X
TaxonomyPersonal Emergency Response Attendant
License Number
License Number StateNY

VIII. Authorized Official

Name: MICHAEL S LIPPE
Title or Position: DIRECTOR
Credential: MD
Phone: 845-368-4800