Provider Demographics
NPI:1669431391
Name:LIPCHIN, JUDITH (PA-C)
Entity type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:
Last Name:LIPCHIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9512 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-3120
Mailing Address - Country:US
Mailing Address - Phone:410-882-0600
Mailing Address - Fax:410-882-2133
Practice Address - Street 1:9512 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-3120
Practice Address - Country:US
Practice Address - Phone:410-882-0600
Practice Address - Fax:410-882-2133
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2016-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000680363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD427ZMedicare ID - Type Unspecified
MDS55419Medicare UPIN