MEDICARE: ALEKSANDR LIPEL PT

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	225100000X	Physical Therapist	023424	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	:	1497721591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEKSANDR LIPEL PT

Provider Business Mailing Address
First Line	:	3715 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1218
Country	:	US
Telephone Number	:	917-612-3971
Fax Number	:	718-934-3330

Provider Business Practice Location Address
First Line	:	3715 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-1218
Country	:	US
Telephone Number	:	917-612-3971
Fax Number	:	718-934-3330

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	07/08/2007

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