MEDICARE: DR. NANCY LIPSITT PH.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
1	103TC0700X	Clinical Psychologist	017466	NY

General Provider Information

NPI Number	:	1295990398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY LIPSITT PH.D

Provider Business Mailing Address
First Line	:	7000 E GENESEE ST STE B2
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-1132
Country	:	US
Telephone Number	:	646-218-1250
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 E GENESEE ST STE B2
Second Line	:
City	:	FAYETTEVILLE
State	:	NY
Zip	:	13066-1132
Country	:	US
Telephone Number	:	646-218-1250
Fax Number	:

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

Provider Enumeration Date	:	07/28/2008
Last Update Date	:	02/05/2026

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