Provider Demographics
NPI:1396956173
Name:CLIFFORD R. LIPMAN, M.D. LLC
Entity type:Organization
Organization Name:CLIFFORD R. LIPMAN, M.D. LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:R
Authorized Official - Last Name:LIPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-497-0300
Mailing Address - Street 1:45 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2686
Mailing Address - Country:US
Mailing Address - Phone:908-497-0300
Mailing Address - Fax:908-497-0304
Practice Address - Street 1:45 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2686
Practice Address - Country:US
Practice Address - Phone:908-497-0300
Practice Address - Fax:908-497-0304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC58280Medicare UPIN
NJ475658Medicare ID - Type Unspecified