Provider Demographics
NPI:1831195577
Name:LIPERT, ZOFIA J (MD)
Entity type:Individual
Prefix:
First Name:ZOFIA
Middle Name:J
Last Name:LIPERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:377 JERSEY AVE
Mailing Address - Street 2:SUITE 420
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4393
Mailing Address - Country:US
Mailing Address - Phone:201-333-0003
Mailing Address - Fax:201-333-0006
Practice Address - Street 1:377 JERSEY AVE
Practice Address - Street 2:SUITE 420
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4393
Practice Address - Country:US
Practice Address - Phone:201-333-0003
Practice Address - Fax:201-333-0006
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA 060948208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6350801Medicaid
G05755Medicare UPIN
NJ6350801Medicaid