Provider Demographics
NPI:1780004218
Name:LIPINSKI, STEPHAN (ATC)
Entity Type:Individual
Prefix:
First Name:STEPHAN
Middle Name:
Last Name:LIPINSKI
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 ST DAVID DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-2906
Mailing Address - Country:US
Mailing Address - Phone:609-585-1434
Mailing Address - Fax:
Practice Address - Street 1:236 ST DAVID DR
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-2906
Practice Address - Country:US
Practice Address - Phone:609-585-1434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-23
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer