Provider Demographics
NPI:1861827693
Name:MARTIN S. LIPSCHUTZ, MD PC
Entity Type:Organization
Organization Name:MARTIN S. LIPSCHUTZ, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:LIPSCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-317-1681
Mailing Address - Street 1:PO BOX 7336
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-0725
Mailing Address - Country:US
Mailing Address - Phone:516-317-1681
Mailing Address - Fax:
Practice Address - Street 1:222 STATION PLZ N STE 514
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-3893
Practice Address - Country:US
Practice Address - Phone:516-317-1681
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-11
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1579552084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty