Provider Demographics
NPI:1457446106
Name:LIPKIN, DEBORAH A (NP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:A
Last Name:LIPKIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 HIGHLAND AVE
Mailing Address - Street 2:CHA-SOMERVILLE TEEN CONNECTION
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-1740
Mailing Address - Country:US
Mailing Address - Phone:617-575-5690
Mailing Address - Fax:617-665-1835
Practice Address - Street 1:81 HIGHLAND AVE
Practice Address - Street 2:CHA-SOMERVILLE TEEN CONNECTION
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02143-1740
Practice Address - Country:US
Practice Address - Phone:617-575-5690
Practice Address - Fax:617-665-1835
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229810363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA66627OtherHARVARD PILGRIM