Provider Demographics
NPI:1770451940
Name:LIPFORD, DELMAR BERNARD SR
Entity type:Individual
Prefix:
First Name:DELMAR
Middle Name:BERNARD
Last Name:LIPFORD
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-2325
Mailing Address - Country:US
Mailing Address - Phone:585-576-5724
Mailing Address - Fax:
Practice Address - Street 1:154 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-2325
Practice Address - Country:US
Practice Address - Phone:585-576-5724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY463101323172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver