Provider Demographics
NPI:1649451824
Name:M. BARRY LIPSON, M.D., LTD.
Entity type:Organization
Organization Name:M. BARRY LIPSON, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:BARRY
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-968-6774
Mailing Address - Street 1:505 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-2144
Mailing Address - Country:US
Mailing Address - Phone:215-968-6774
Mailing Address - Fax:215-968-1976
Practice Address - Street 1:505 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-2144
Practice Address - Country:US
Practice Address - Phone:215-968-6774
Practice Address - Fax:215-968-1976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD008879E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC27365Medicare UPIN