Provider Demographics
NPI:1528046133
Name:LIPSKY, HAROLD L (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:L
Last Name:LIPSKY
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 1:2000 N VILLAGE AVE STE 411
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1001
Mailing Address - Country:US
Mailing Address - Phone:516-593-4451
Mailing Address - Fax:516-593-6202
Practice Address - Street 1:2000 N VILLAGE AVE STE 411
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-1001
Practice Address - Country:US
Practice Address - Phone:516-593-4451
Practice Address - Fax:516-593-6202
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY180357174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01441827Medicaid
NY01441827Medicaid
NY02J782Medicare PIN