Provider Demographics
NPI:1104200468
Name:STIPPA, NIGEL A (MD)
Entity Type:Individual
Prefix:
First Name:NIGEL
Middle Name:A
Last Name:STIPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 WILLIAMS ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7462
Mailing Address - Country:US
Mailing Address - Phone:413-445-4564
Mailing Address - Fax:413-448-2727
Practice Address - Street 1:740 WILLIAMS ST STE 3
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7462
Practice Address - Country:US
Practice Address - Phone:413-445-4564
Practice Address - Fax:413-448-2727
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA282689207W00000X
AZ57912207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology