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General NPI Number Information
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NPI Number | 1780821132
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Entity Type | Organization
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Legal Business Name | MAMIE LIPARI, M.D. P.C.
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Dates
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Enumeration Date | 01/07/2009
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Last Update Date | 08/14/2009
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Provider Practice Location Address
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Address Line | 20228 45TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11361-2540
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Country | US
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Telephone | 718-701-5941
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Fax | 718-423-7696
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Provider Business Mailing Address
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Address Line | 21445 29TH AVE
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City | BAYSIDE
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State | NY
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Zip | 11360-2648
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Country | US
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Telephone | 718-701-5941
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Fax | 718-423-7696
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAMIE LIPARI
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Credential | M.D.
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Telephone | 718-701-5941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 190651
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License Number State | NY
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