Provider Demographics
NPI:1952364077
Name:LIPPITT, ELIZABETH CLAIRE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CLAIRE
Last Name:LIPPITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4781 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10034-4915
Mailing Address - Country:US
Mailing Address - Phone:718-716-4400
Mailing Address - Fax:718-228-7471
Practice Address - Street 1:4781 BROADWAY
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-4915
Practice Address - Country:US
Practice Address - Phone:212-304-6920
Practice Address - Fax:212-544-5849
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY231483207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1824600Medicaid
NY1824600Medicaid
NYBL7218832OtherDEA
NYA34645Medicare ID - Type Unspecified