Provider Demographics
NPI:1992810832
Name:LIPAJ, ANNETTE
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:
Last Name:LIPAJ
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 1:1525 KINGSWAY
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2616
Mailing Address - Country:US
Mailing Address - Phone:216-871-3381
Mailing Address - Fax:
Practice Address - Street 1:1909 N RIDGE RD E
Practice Address - Street 2:STE 3
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44055-3379
Practice Address - Country:US
Practice Address - Phone:440-277-9101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH01971OtherLICENSE #