Provider Demographics
NPI:1003940396
Name:LIPNER, STEWART (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEWART
Middle Name:
Last Name:LIPNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7559 263RD ST
Mailing Address - Street 2:ZUCKER HILLSIDE HOSPITAL/LIJ/PSYCHOLOGICAL SERVICES
Mailing Address - City:GLEN OAKS
Mailing Address - State:NY
Mailing Address - Zip Code:11004-1150
Mailing Address - Country:US
Mailing Address - Phone:718-470-8096
Mailing Address - Fax:718-962-7717
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:ZUCKER HILLSIDE HOSPITAL/LIJ
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:718-470-8096
Practice Address - Fax:718-962-7717
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8610103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist