Provider Demographics
NPI:1174677454
Name:LIPSKI, ROBERT L (OD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:L
Last Name:LIPSKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2212 OLD TURNPIKE RD
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-6521
Mailing Address - Country:US
Mailing Address - Phone:570-523-9234
Mailing Address - Fax:570-523-9235
Practice Address - Street 1:2212 OLD TURNPIKE RD
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-6521
Practice Address - Country:US
Practice Address - Phone:570-523-9234
Practice Address - Fax:570-523-9235
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOE007292P152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA682787PZ8Medicare ID - Type Unspecified
PAU19931Medicare UPIN