Provider Demographics
NPI:1528019684
Name:LIPMAN, SIDNEY PHILIP (MD)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:PHILIP
Last Name:LIPMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1645 W 8TH ST
Mailing Address - Street 2:#200
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-5007
Mailing Address - Country:US
Mailing Address - Phone:814-864-9994
Mailing Address - Fax:814-866-2655
Practice Address - Street 1:1645 W 8TH ST
Practice Address - Street 2:#200
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-5007
Practice Address - Country:US
Practice Address - Phone:814-864-9994
Practice Address - Fax:814-866-2655
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD023682E207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007647400002Medicaid
PAB40202Medicare UPIN
PA157587KYFMedicare PIN