Provider Demographics
NPI:1467447979
Name:LIPSON, RAMI (DC)
Entity Type:Individual
Prefix:
First Name:RAMI
Middle Name:
Last Name:LIPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 N 32ND ST
Mailing Address - Street 2:STE 110
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-3953
Mailing Address - Country:US
Mailing Address - Phone:602-956-9595
Mailing Address - Fax:602-956-3232
Practice Address - Street 1:4400 N 32ND ST
Practice Address - Street 2:STE 110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-3953
Practice Address - Country:US
Practice Address - Phone:602-956-9595
Practice Address - Fax:602-956-3232
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5729111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU68322Medicare UPIN
AZ85460Medicare ID - Type Unspecified