Provider Demographics
NPI:1265796171
Name:LIPSKY, JENNIFER BRACHMAN
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:BRACHMAN
Last Name:LIPSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 BUTTERNUT PL
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-3906
Mailing Address - Country:US
Mailing Address - Phone:203-434-2249
Mailing Address - Fax:
Practice Address - Street 1:11 BUTTERNUT PL
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-3906
Practice Address - Country:US
Practice Address - Phone:203-434-2249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-26
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist