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NPI Code Detail

MEDICARE: DR. LEE TRIPP M.D.

MEDICARE: DR. LEE TRIPP M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VG0400XGynecology PhysicianMD037200EPA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10052753000OTHERPAIBC PROVIDER #

General Provider Information

NPI Number : 1164555249
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LEE TRIPP M.D.
Provider Business Mailing Address
First Line : 1144 LOCUST ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-6734
Country : US
Telephone Number : 215-351-5500
Fax Number : 215-351-5595
Provider Business Practice Location Address
First Line : 1144 LOCUST ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19107-6734
Country : US
Telephone Number : 215-351-5500
Fax Number : 215-351-5595
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 07/08/2007

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Directions to “ DR. LEE TRIPP M.D.” Practice Location

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