Provider Demographics
NPI:1972262392
Name:LIPKA, ANNA MALGORZATA (RD)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:MALGORZATA
Last Name:LIPKA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 SUMMER HILL RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-1851
Mailing Address - Country:US
Mailing Address - Phone:203-848-4574
Mailing Address - Fax:
Practice Address - Street 1:43 SUMMER HILL RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-1851
Practice Address - Country:US
Practice Address - Phone:860-202-5479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-13
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1065616133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered