Provider Demographics
NPI:1699858662
Name:LIPPMANN, STEPHEN G (MS, LAC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:G
Last Name:LIPPMANN
Suffix:
Gender:M
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N CENTRAL AVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:HARTSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10530-1903
Mailing Address - Country:US
Mailing Address - Phone:914-949-9009
Mailing Address - Fax:
Practice Address - Street 1:111 N CENTRAL AVE
Practice Address - Street 2:SUITE 403
Practice Address - City:HARTSDALE
Practice Address - State:NY
Practice Address - Zip Code:10530-1903
Practice Address - Country:US
Practice Address - Phone:914-949-9009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002148171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist