Provider Demographics
NPI:1821721382
Name:LIPPE, MARGOT (BS, MA)
Entity Type:Individual
Prefix:MRS
First Name:MARGOT
Middle Name:
Last Name:LIPPE
Suffix:
Gender:F
Credentials:BS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CAT HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11709-3017
Mailing Address - Country:US
Mailing Address - Phone:516-993-1798
Mailing Address - Fax:
Practice Address - Street 1:255 EXECUTIVE DR STE LL
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-1719
Practice Address - Country:US
Practice Address - Phone:516-576-2040
Practice Address - Fax:516-744-2757
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-02
Last Update Date:2022-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY674001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist