MEDICARE: ANDREW CHARLES LIPKA MD

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	207W00000X	Ophthalmology Physician	25MA04790500	NJ

General Provider Information

NPI Number	:	1821199043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW CHARLES LIPKA MD

Provider Business Mailing Address
First Line	:	800 BUNN DR
Second Line	:	SUITE 301
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1968
Country	:	US
Telephone Number	:	609-924-3700
Fax Number	:	609-924-4724

Provider Business Practice Location Address
First Line	:	800 BUNN DR
Second Line	:	SUITE 301
City	:	PRINCETON
State	:	NJ
Zip	:	08540-1968
Country	:	US
Telephone Number	:	609-924-3700
Fax Number	:	609-924-4724

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

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	01/21/2011

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