Provider Demographics
NPI:1912935297
Name:LIPSHULTZ, STEVEN E (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:LIPSHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1001 MAIN ST FL 5
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14203-1009
Mailing Address - Country:US
Mailing Address - Phone:716-323-0014
Mailing Address - Fax:716-323-0293
Practice Address - Street 1:1001 MAIN ST FL 4
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1009
Practice Address - Country:US
Practice Address - Phone:716-323-0014
Practice Address - Fax:716-323-0293
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME893212080P0202X
NY2052942080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2689294-00Medicaid
FLA59348Medicare UPIN
FL2689294-00Medicaid