Provider Demographics
NPI:1699770768
Name:LIPSYC, JOAN S
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:S
Last Name:LIPSYC
Suffix:
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 1:26025 SHAKER BLVD
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7107
Mailing Address - Country:US
Mailing Address - Phone:216-292-4646
Mailing Address - Fax:216-292-2822
Practice Address - Street 1:26025 SHAKER BLVD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-7107
Practice Address - Country:US
Practice Address - Phone:216-292-4646
Practice Address - Fax:216-292-2822
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-17484183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist