Provider Demographics
NPI:1790517340
Name:LIPPINCOTT, JULIA KLEIN (AGNP)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:KLEIN
Last Name:LIPPINCOTT
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 IRVING PL APT G20D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9708
Mailing Address - Country:US
Mailing Address - Phone:330-714-4168
Mailing Address - Fax:
Practice Address - Street 1:787 11TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3584
Practice Address - Country:US
Practice Address - Phone:212-523-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY311910363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health