Provider Demographics
NPI:1760487649
Name:LIPKIN, WILLIAM JAY (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:JAY
Last Name:LIPKIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 BLOOMFIELD ST
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-4911
Mailing Address - Country:US
Mailing Address - Phone:201-656-4608
Mailing Address - Fax:201-656-4633
Practice Address - Street 1:500 BLOOMFIELD ST
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-4911
Practice Address - Country:US
Practice Address - Phone:201-656-4608
Practice Address - Fax:201-656-4633
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMD2482213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU61721Medicare UPIN
NJ017755Medicare ID - Type Unspecified
NJ4055310001Medicare NSC