Provider Demographics
NPI:1003167651
Name:LIPINSKI, PETER (DPT)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:
Last Name:LIPINSKI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 FREEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-3122
Mailing Address - Country:US
Mailing Address - Phone:516-998-8970
Mailing Address - Fax:
Practice Address - Street 1:1065 OLD COUNTRY RD
Practice Address - Street 2:SUITE 214
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-5640
Practice Address - Country:US
Practice Address - Phone:516-334-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-23
Last Update Date:2012-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353712251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic