Provider Demographics
NPI:1366591307
Name:LIPSON, SUSAN R (MD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:R
Last Name:LIPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:801 OSTRUM ST
Mailing Address - Street 2:ENROLLMENT CENTER
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1000
Mailing Address - Country:US
Mailing Address - Phone:484-526-6048
Mailing Address - Fax:484-526-6500
Practice Address - Street 1:8330 EASTON RD STE C
Practice Address - Street 2:
Practice Address - City:OTTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18942-1615
Practice Address - Country:US
Practice Address - Phone:267-424-8020
Practice Address - Fax:866-326-8660
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD427699207Q00000X
DEC10009268207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA067434OtherMEDICARE GROUP