Provider Demographics
NPI:1396134672
Name:LIPOWSKI, DANIELLE LYNN X
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LYNN
Last Name:LIPOWSKI
Suffix:X
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:471 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-3622
Mailing Address - Country:US
Mailing Address - Phone:201-339-8181
Mailing Address - Fax:
Practice Address - Street 1:471 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3622
Practice Address - Country:US
Practice Address - Phone:201-339-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ28RI03473000183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist