Provider Demographics
NPI:1689922650
Name:LIFTON, RICHARD P (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:LIFTON
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 1:300 CEDAR ST
Mailing Address - Street 2:TAC S341D
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06519-1612
Mailing Address - Country:US
Mailing Address - Phone:203-737-1091
Mailing Address - Fax:203-785-7560
Practice Address - Street 1:300 CEDAR ST
Practice Address - Street 2:TAC S341D
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1612
Practice Address - Country:US
Practice Address - Phone:203-737-1091
Practice Address - Fax:203-785-7560
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-26
Last Update Date:2012-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT034123207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine