Provider Demographics
NPI:1497036008
Name:LIPMAN, LEONARD H
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:H
Last Name:LIPMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 CONSTITUTION CIR
Mailing Address - Street 2:
Mailing Address - City:N BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-3532
Mailing Address - Country:US
Mailing Address - Phone:732-846-5799
Mailing Address - Fax:
Practice Address - Street 1:1153 VALLEY RD
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1500
Practice Address - Country:US
Practice Address - Phone:908-394-2090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI01166000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist