Provider Demographics
NPI:1326033374
Name:LIPCHITZ, MARTHA C (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:C
Last Name:LIPCHITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 CARDIGAN RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-1207
Mailing Address - Country:US
Mailing Address - Phone:978-851-9842
Mailing Address - Fax:978-851-6184
Practice Address - Street 1:190 CARDIGAN RD
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-1207
Practice Address - Country:US
Practice Address - Phone:978-851-9842
Practice Address - Fax:978-851-6184
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31263208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0121266Medicaid
MAH13946Medicare UPIN
MAH30832Medicare ID - Type Unspecified