Provider Demographics
NPI:1801866132
Name:LIPSZTEIN, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:LIPSZTEIN
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 1:106-14 70TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:718-520-6620
Mailing Address - Fax:718-520-6630
Practice Address - Street 1:106-14 70TH AVENUE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-520-6620
Practice Address - Fax:718-520-6630
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY143484174400000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0063735OtherGHI
NY166050OtherELDERPLAN
NY00794909Medicaid
NY113089245OtherTAX ID
NYNS757OtherOXFORD
NY0C5533OtherHEALTHNET
NY27091POtherHIP
NY85A362Medicare PIN
NY113089245OtherTAX ID
NY00863HMedicare PIN