Provider Demographics
NPI:1801197413
Name:ACE LIPSON, MD PC
Entity type:Organization
Organization Name:ACE LIPSON, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ACE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-296-3443
Mailing Address - Street 1:1120 19TH ST NW
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-3605
Mailing Address - Country:US
Mailing Address - Phone:202-296-3443
Mailing Address - Fax:202-296-8948
Practice Address - Street 1:1120 19TH ST NW
Practice Address - Street 2:SUITE 200
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-3605
Practice Address - Country:US
Practice Address - Phone:202-296-3443
Practice Address - Fax:202-296-8948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD7663174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B94730Medicare UPIN
412922Medicare PIN