Provider Demographics
NPI:1003296278
Name:LIPSON, NECHAMA
Entity Type:Individual
Prefix:
First Name:NECHAMA
Middle Name:
Last Name:LIPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 LAUREL PARK RD APT D16
Mailing Address - Street 2:
Mailing Address - City:FALLSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12733-5054
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:53 LAUREL PARK RD APT D16
Practice Address - Street 2:
Practice Address - City:FALLSBURG
Practice Address - State:NY
Practice Address - Zip Code:12733-5054
Practice Address - Country:US
Practice Address - Phone:845-436-6780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst