MEDICARE: MARIE A LIPPMAN MD

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
1	2084P0804X	Child & Adolescent Psychiatry Physician	180173	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295846061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIE A LIPPMAN MD

Provider Business Mailing Address
First Line	:	55 CLIFFIELD ROAD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506
Country	:	US
Telephone Number	:	516-359-9599
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 CLIFFIELD RD
Second Line	:
City	:	BEDFORD
State	:	NY
Zip	:	10506-1210
Country	:	US
Telephone Number	:	516-359-9599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/21/2022

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