Provider Demographics
NPI:1821199043
Name:LIPKA, ANDREW CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:CHARLES
Last Name:LIPKA
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 1:800 BUNN DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-1968
Mailing Address - Country:US
Mailing Address - Phone:609-924-3700
Mailing Address - Fax:609-924-4724
Practice Address - Street 1:800 BUNN DR
Practice Address - Street 2:SUITE 301
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-1968
Practice Address - Country:US
Practice Address - Phone:609-924-3700
Practice Address - Fax:609-924-4724
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2011-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04790500207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P527170Medicare ID - Type Unspecified
A64159Medicare UPIN