Provider Demographics
NPI:1568543478
Name:ARNOLD A. LIPTON, MD, PC
Entity Type:Organization
Organization Name:ARNOLD A. LIPTON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:A
Authorized Official - Last Name:LIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-384-1607
Mailing Address - Street 1:119 MCKIBBEN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-2608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:119 MCKIBBEN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-2608
Practice Address - Country:US
Practice Address - Phone:718-384-1607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093257174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00151588Medicaid
NY00151588Medicaid
NYB15125Medicare UPIN