Healthcare Provider Details

I. General information

NPI: 1265401830
Provider Name (Legal Business Name): LOUIS B. LIPSCHUTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 07/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

175 RIDINGS WAY
AMBLER PA
19002-5245
US

IV. Provider business mailing address

175 RIDINGS WAY
AMBLER PA
19002-5245
US

V. Phone/Fax

Practice location:
  • Phone: 610-853-3370
  • Fax: 215-641-4925
Mailing address:
  • Phone: 610-853-3370
  • Fax: 215-641-4925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD030120E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: