Individual
LISA S. IPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
535 E 70TH ST, NEW YORK, NY 10021-4823
(212) 774-7182
Mailing address
PO BOX 29234, NEW YORK, NY 10087-9234
(212) 774-7182
(212) 746-7481
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
213819
NY
208000000X
Pediatrics Physician
Primary
213819
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02281001
—
NY
Enumeration date
10/09/2006
Last updated
12/22/2020
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