Provider Demographics
NPI:1497789994
Name:LIPPIN, RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:LIPPIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 HAP ARNOLD BLVD
Mailing Address - Street 2:OCCUPATIONAL HEALTH CLINIC-TOBYHANNA ARMY DEPOT
Mailing Address - City:TOBYHANNA
Mailing Address - State:PA
Mailing Address - Zip Code:18466-5083
Mailing Address - Country:US
Mailing Address - Phone:570-895-6242
Mailing Address - Fax:570-895-6783
Practice Address - Street 1:11 HAP ARNOLD BLVD
Practice Address - Street 2:OCCUPATIONAL HEALTH CLINIC-TOBYHANNA ARMY DEPOT
Practice Address - City:TOBYHANNA
Practice Address - State:PA
Practice Address - Zip Code:18466-5002
Practice Address - Country:US
Practice Address - Phone:570-895-6242
Practice Address - Fax:570-895-6783
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2020-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013443E2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYVAD000Medicare UPIN
NY33025FMedicare ID - Type Unspecified