Provider Demographics
NPI:1184721771
Name:LIPSHUTZ, LAUREL S (MD)
Entity type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:S
Last Name:LIPSHUTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:601 WALNUT ST
Mailing Address - Street 2:THE CURTIS CENTER, SUITE 960W
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3332
Mailing Address - Country:US
Mailing Address - Phone:215-923-7851
Mailing Address - Fax:215-592-7853
Practice Address - Street 1:601 WALNUT ST
Practice Address - Street 2:THE CURTIS CENTER, SUITE 960W
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3332
Practice Address - Country:US
Practice Address - Phone:215-923-7851
Practice Address - Fax:215-592-7853
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD016275E2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALI89426OtherBLUE CROSS/BLUE SHIELD
PAB35410Medicare UPIN