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NPI Code Detail

MEDICARE: DR. JULIE A. KIPP PH.D.

MEDICARE: DR. JULIE A. KIPP 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
11041C0700XClinical Social WorkerR041791NY

General Provider Information

NPI Number : 1629164363
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIE A. KIPP PH.D.
Provider Business Mailing Address
First Line : 18 NEPPERHAN AVE
Second Line :
City : HASTINGS ON HUDSON
State : NY
Zip : 10706-4015
Country : US
Telephone Number : 914-478-5972
Fax Number :
Provider Business Practice Location Address
First Line : 55 WESTCHESTER SQ
Second Line : BRONX REAL
City : BRONX
State : NY
Zip : 10461-3525
Country : US
Telephone Number : 718-931-4045
Fax Number : 718-828-1329
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2006
Last Update Date : 07/08/2007

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