Provider Demographics
NPI:1366874117
Name:LIPTAK, THOMAS PAUL (RPH)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PAUL
Last Name:LIPTAK
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8870 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:NORTH HUNTINGDON
Mailing Address - State:PA
Mailing Address - Zip Code:15642-8718
Mailing Address - Country:US
Mailing Address - Phone:724-863-5442
Mailing Address - Fax:724-863-5443
Practice Address - Street 1:8870 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-8718
Practice Address - Country:US
Practice Address - Phone:724-863-5442
Practice Address - Fax:724-863-5443
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-04
Last Update Date:2013-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP032391L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist