Provider Demographics
NPI:1275612111
Name:LIPANI, JOHN DAVID (MD, PHD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:LIPANI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3836 QUAKERBRIDGE RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-1006
Mailing Address - Country:US
Mailing Address - Phone:609-890-3400
Mailing Address - Fax:609-890-3410
Practice Address - Street 1:3836 QUAKERBRIDGE RD
Practice Address - Street 2:SUITE 203
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-1006
Practice Address - Country:US
Practice Address - Phone:609-890-3400
Practice Address - Fax:609-890-3410
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08134300207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery