Provider Demographics
NPI:1619612736
Name:LIPINSKI, SEAN C (RN)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:C
Last Name:LIPINSKI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1142 JOHNSONVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12094-3423
Mailing Address - Country:US
Mailing Address - Phone:518-321-2168
Mailing Address - Fax:
Practice Address - Street 1:1142 JOHNSONVILLE RD
Practice Address - Street 2:
Practice Address - City:JOHNSONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12094-3423
Practice Address - Country:US
Practice Address - Phone:518-321-2168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY673571163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
22506179OtherNCSBN ID