Provider Demographics
NPI:1851478739
Name:LIPSON, ACE (MD)
Entity Type:Individual
Prefix:
First Name:ACE
Middle Name:
Last Name:LIPSON
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 1:1120 19TH ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3615
Mailing Address - Country:US
Mailing Address - Phone:202-296-3443
Mailing Address - Fax:202-296-8948
Practice Address - Street 1:1120 19TH ST NW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3615
Practice Address - Country:US
Practice Address - Phone:202-296-3443
Practice Address - Fax:202-296-8948
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD7663174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
B94730Medicare UPIN
412922Medicare ID - Type Unspecified