Provider Demographics
NPI:1902317852
Name:LIPPMANN, EMILIE PAULA (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:EMILIE
Middle Name:PAULA
Last Name:LIPPMANN
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2134
Mailing Address - Country:US
Mailing Address - Phone:914-261-0186
Mailing Address - Fax:
Practice Address - Street 1:10 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-2134
Practice Address - Country:US
Practice Address - Phone:914-261-0186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2017-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty