Provider Demographics
NPI:1891976122
Name:LIPPMANN, JOSHUA
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:
Last Name:LIPPMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 DANBURY RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4304
Mailing Address - Country:US
Mailing Address - Phone:203-885-3783
Mailing Address - Fax:
Practice Address - Street 1:60 CROSS HWY
Practice Address - Street 2:COTTAGE
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-2404
Practice Address - Country:US
Practice Address - Phone:203-664-1269
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000412171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist