Provider Demographics
NPI:1861628596
Name:STEVEN E. LIPSON, DPM
Entity Type:Organization
Organization Name:STEVEN E. LIPSON, DPM
Other - Org Name:TYSONS CORNER FOOT & ANKLE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:703-893-6411
Mailing Address - Street 1:8206 LEESBURG PIKE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:VIENNA
Mailing Address - State:VA
Mailing Address - Zip Code:22182-2614
Mailing Address - Country:US
Mailing Address - Phone:703-893-6411
Mailing Address - Fax:703-893-6415
Practice Address - Street 1:8206 LEESBURG PIKE
Practice Address - Street 2:SUITE 401
Practice Address - City:VIENNA
Practice Address - State:VA
Practice Address - Zip Code:22182-2614
Practice Address - Country:US
Practice Address - Phone:703-893-6411
Practice Address - Fax:703-893-6415
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-09
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA9300767Medicaid
VA9300767Medicaid
108939Medicare PIN
6234690001Medicare NSC