Provider Demographics
NPI:1720057938
Name:LIPPI, MARK A (DC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:LIPPI
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 STRAWBERRY SQ
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17101-1815
Mailing Address - Country:US
Mailing Address - Phone:717-238-5010
Mailing Address - Fax:717-238-9510
Practice Address - Street 1:146 STRAWBERRY SQ
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-1815
Practice Address - Country:US
Practice Address - Phone:717-238-5010
Practice Address - Fax:717-238-9510
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-17
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC007261L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA02417700OtherCAPITAL BLUE CROSS
PA7252218OtherAETNA PPO
PALI019394OtherBLUE SHIELD
PA2531553OtherAETNA HMO
PAU73969Medicare UPIN
PA020061Medicare ID - Type Unspecified