Provider Demographics
NPI:1811407497
Name:LIPPMAN, MARCELLA
Entity Type:Individual
Prefix:
First Name:MARCELLA
Middle Name:
Last Name:LIPPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-0510
Mailing Address - Country:US
Mailing Address - Phone:609-746-9457
Mailing Address - Fax:
Practice Address - Street 1:7 EAST MAIN STREET
Practice Address - Street 2:
Practice Address - City:TUCKERTON
Practice Address - State:NJ
Practice Address - Zip Code:08087-2000
Practice Address - Country:US
Practice Address - Phone:609-746-9457
Practice Address - Fax:609-812-5112
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00828700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty