Provider Demographics
NPI:1629416037
Name:SCOTT DAVID LIPPE, MD., LLC
Entity Type:Organization
Organization Name:SCOTT DAVID LIPPE, MD., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-225-4700
Mailing Address - Street 1:230 E RIDGEWOOD AVE
Mailing Address - Street 2:STE 6-2
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-4142
Mailing Address - Country:US
Mailing Address - Phone:201-225-4700
Mailing Address - Fax:201-225-4702
Practice Address - Street 1:230 E RIDGEWOOD AVE
Practice Address - Street 2:STE 6-2
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-4142
Practice Address - Country:US
Practice Address - Phone:201-225-4700
Practice Address - Fax:201-225-4702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-07
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty