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NPI Code Detail

MEDICARE: SONIA LIPSON NP

MEDICARE: SONIA LIPSON NP
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
1363L00000XNurse Practitioner159915MA

Other Identifiers

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

General Provider Information

NPI Number : 1396730800
Entity Type Code : Individual
Provider Name (Legal Business Name) : SONIA LIPSON NP
Provider Business Mailing Address
First Line : 398 NEPONSET AVENUE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122
Country : US
Telephone Number : 617-282-3200
Fax Number : 617-265-9719
Provider Business Practice Location Address
First Line : 398 NEPONSET AVE
Second Line :
City : DORCHESTER
State : MA
Zip : 02122-3134
Country : US
Telephone Number : 617-282-3200
Fax Number : 617-265-9719
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2005
Last Update Date : 06/10/2013

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