Provider Demographics
NPI:1740217926
Name:LIPSTAS, AIMEE (PT)
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:
Last Name:LIPSTAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:DONOHUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1602 NEWPORT GAP PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19808-6208
Mailing Address - Country:US
Mailing Address - Phone:302-633-5840
Mailing Address - Fax:302-633-5844
Practice Address - Street 1:750 PRIDES XING STE 112
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-6107
Practice Address - Country:US
Practice Address - Phone:302-894-2222
Practice Address - Fax:302-907-4028
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT013944L225100000X
DEJ10001701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
291865OtherMAMSI
2140876000OtherAMERIHEALTH IBC
2140876000OtherAMERIHEALTH
DE10000037708Medicaid
1455522OtherPABS
2140876000OtherAMERIHEALTH IBC
291865OtherMAMSI
DE10000037708Medicaid
P00635531Medicare PIN
1455522OtherPABS
2140876000OtherAMERIHEALTH IBC