Provider Demographics
NPI:1912012071
Name:LIPSON, ADAM CRAIG (MD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:CRAIG
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 1:1057 COMMERCE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-5025
Mailing Address - Country:US
Mailing Address - Phone:908-688-8800
Mailing Address - Fax:908-688-2377
Practice Address - Street 1:1057 COMMERCE AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-5025
Practice Address - Country:US
Practice Address - Phone:908-688-8800
Practice Address - Fax:908-688-2377
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08404800207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08404800OtherNJ LICENSE
NJ25MA08404800OtherNJ LICENSE