Provider Demographics
NPI:1790783850
Name:LIPAT, GREGORIO (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORIO
Middle Name:
Last Name:LIPAT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1 HAMILTON DR E
Mailing Address - Street 2:
Mailing Address - City:NORTH CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-4602
Mailing Address - Country:US
Mailing Address - Phone:201-200-9984
Mailing Address - Fax:201-451-2863
Practice Address - Street 1:107 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-3217
Practice Address - Country:US
Practice Address - Phone:201-200-9984
Practice Address - Fax:201-451-2863
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02867500207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC56252Medicare UPIN