Provider Demographics
NPI:1932647229
Name:LIPPMAN, DEENA
Entity Type:Individual
Prefix:
First Name:DEENA
Middle Name:
Last Name:LIPPMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DEENA
Other - Middle Name:
Other - Last Name:LIPPMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-0802
Mailing Address - Country:US
Mailing Address - Phone:516-607-6312
Mailing Address - Fax:
Practice Address - Street 1:7 DEBBIE TRAIL
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946
Practice Address - Country:US
Practice Address - Phone:516-607-6312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641947163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse