Provider Demographics
NPI:1518114073
Name:LIPTZIN, SCOTT EVAN (DPT)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:EVAN
Last Name:LIPTZIN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 BAY AVE
Mailing Address - Street 2:
Mailing Address - City:HICKSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11801-3110
Mailing Address - Country:US
Mailing Address - Phone:516-557-9564
Mailing Address - Fax:516-373-7002
Practice Address - Street 1:35 BAY AVE
Practice Address - Street 2:
Practice Address - City:HICKSVILLE
Practice Address - State:NY
Practice Address - Zip Code:11801-3110
Practice Address - Country:US
Practice Address - Phone:516-557-9564
Practice Address - Fax:516-373-7002
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist