1033732326 NPI number — KAITLIN VICTORIA LIPNER MD

Table of content: KAITLIN VICTORIA LIPNER MD (NPI 1033732326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033732326 NPI number — KAITLIN VICTORIA LIPNER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIPNER
Provider First Name:
KAITLIN
Provider Middle Name:
VICTORIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033732326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
RHODE ISLAND HOSPITAL
Provider Second Line Business Mailing Address:
593 EDDY STREET
Provider Business Mailing Address City Name:
PROVIDECE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-444-6489
Provider Business Mailing Address Fax Number:
401-444-6662

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
RHODE ISLAND HOSPITAL
Provider Second Line Business Practice Location Address:
593 EDDY STREET
Provider Business Practice Location Address City Name:
PROVIDECE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-444-6489
Provider Business Practice Location Address Fax Number:
401-444-6662
Provider Enumeration Date:
05/21/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  LP04957 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)