Provider Demographics
NPI:1922322338
Name:LIPPELL, IRA MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:IRA
Middle Name:MARK
Last Name:LIPPELL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 AVENUE D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5338
Mailing Address - Country:US
Mailing Address - Phone:212-228-0400
Mailing Address - Fax:212-533-0236
Practice Address - Street 1:93 AVENUE D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-5338
Practice Address - Country:US
Practice Address - Phone:212-228-0400
Practice Address - Fax:212-533-0236
Is Sole Proprietor?:No
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30232183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist