1932182680 NPI number — JEFFREY TYSON LIPMAN R.PH.

Table of content: ANGELA MARIE CHRISTIAN-WILLIAMS PT, DPT (NPI 1013730670)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932182680 NPI number — JEFFREY TYSON LIPMAN R.PH.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIPMAN
Provider First Name:
JEFFREY
Provider Middle Name:
TYSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
R.PH.
Provider Gender Code:
M

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:
1932182680
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
106 CONOY ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17104-1616
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-236-0028
Provider Business Mailing Address Fax Number:
888-792-7069

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3544 N PROGRESS AVE
Provider Second Line Business Practice Location Address:
MORGAN HEALTHCARE AUDITS LLC
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-9480
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-540-0852
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2005

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: 183500000X , with the licence number:  RP028100L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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