Provider Demographics
NPI:1689850364
Name:DR. LINDA LIPSTEIN, O.D., LLC
Entity Type:Organization
Organization Name:DR. LINDA LIPSTEIN, O.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:970-672-4452
Mailing Address - Street 1:1510 W MAIN ST
Mailing Address - Street 2:VISION CENTER
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-9095
Mailing Address - Country:US
Mailing Address - Phone:970-672-4452
Mailing Address - Fax:
Practice Address - Street 1:1510 W MAIN ST
Practice Address - Street 2:VISION CENTER
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-9095
Practice Address - Country:US
Practice Address - Phone:970-672-4452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-13
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1936152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU67538Medicare UPIN
CO49213Medicare PIN