Provider Demographics
NPI:1922491786
Name:TOLIPANO, DEBORAH KIM (MS ED)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:KIM
Last Name:TOLIPANO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 DENTON DR
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5114
Mailing Address - Country:US
Mailing Address - Phone:516-223-2252
Mailing Address - Fax:
Practice Address - Street 1:3111 DENTON DR
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-5114
Practice Address - Country:US
Practice Address - Phone:516-223-2252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-17
Last Update Date:2017-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60394171M00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator