Provider Demographics
NPI:1497928881
Name:LOUIS B. LIPSCHUTZ,M.D.,PC
Entity Type:Organization
Organization Name:LOUIS B. LIPSCHUTZ,M.D.,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:LIPSCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-853-3370
Mailing Address - Street 1:175 RIDINGS WAY
Mailing Address - Street 2:
Mailing Address - City:AMBLER
Mailing Address - State:PA
Mailing Address - Zip Code:19002-5245
Mailing Address - Country:US
Mailing Address - Phone:610-853-3370
Mailing Address - Fax:215-641-4925
Practice Address - Street 1:175 RIDINGS WAY
Practice Address - Street 2:
Practice Address - City:AMBLER
Practice Address - State:PA
Practice Address - Zip Code:19002-5245
Practice Address - Country:US
Practice Address - Phone:610-853-3370
Practice Address - Fax:215-641-4925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD030120-E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010572500005Medicaid
1758663OtherPA BLUE SHIELD
PA0010572500005Medicaid