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General NPI Number Information
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NPI Number | 1467457218
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Entity Type | Individual
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Provider Name | ANITA LIPSON MD
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Gender | Female
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Dates
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Enumeration Date | 06/17/2005
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Last Update Date | 03/30/2020
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Provider Practice Location Address
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Address Line | 827 BLACK ROCK RD
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City | GLADWYNE
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State | PA
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Zip | 19035-1402
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Country | US
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Telephone | 215-760-5544
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Fax | 888-511-3045
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Provider Business Mailing Address
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Address Line | PO BOX 597
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City | WOODY CREEK
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State | CO
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Zip | 81656-0597
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Country | US
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Telephone | 215-760-5544
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | MD041229E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | DR.0063043
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | DR.0063043
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 207UN0901X
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Taxonomy Name | Nuclear Cardiology Physician
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License Number | MD041229E
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License Number State | PA
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