MEDICARE: DR. WILLIAM JAY LIPKIN D.P.M.

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	213ES0103X	Foot & Ankle Surgery Podiatrist	MD2482	NJ

General Provider Information

NPI Number	:	1760487649
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM JAY LIPKIN D.P.M.

Provider Business Mailing Address
First Line	:	500 BLOOMFIELD ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4911
Country	:	US
Telephone Number	:	201-656-4608
Fax Number	:	201-656-4633

Provider Business Practice Location Address
First Line	:	500 BLOOMFIELD ST
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030-4911
Country	:	US
Telephone Number	:	201-656-4608
Fax Number	:	201-656-4633

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/26/2007

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