Provider Demographics
NPI:1902054182
Name:LIPSHUTZ, ANGELA KELLIHER MANCUSO (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:KELLIHER MANCUSO
Last Name:LIPSHUTZ
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:MS
Other - First Name:ANGELA
Other - Middle Name:KELLIHER
Other - Last Name:MANCUSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:513 PARNASSUS AVE
Mailing Address - Street 2:RM S-455
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0470
Mailing Address - Country:US
Mailing Address - Phone:415-476-1239
Mailing Address - Fax:
Practice Address - Street 1:1355 PICCARD DR STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4317
Practice Address - Country:US
Practice Address - Phone:301-921-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-30
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0081313207LH0002X, 207L00000X, 207LC0200X
CAA112586207L00000X, 207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LH0002XAllopathic & Osteopathic PhysiciansAnesthesiologyHospice and Palliative Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine