Provider Demographics
NPI:1235710831
Name:LIPNER, MATTHEW BENJAMIN
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:BENJAMIN
Last Name:LIPNER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NEW HAMPSHIRE AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-2864
Mailing Address - Country:US
Mailing Address - Phone:330-947-6021
Mailing Address - Fax:
Practice Address - Street 1:135 HOOKSETT RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-2641
Practice Address - Country:US
Practice Address - Phone:603-441-1076
Practice Address - Fax:603-369-4663
Is Sole Proprietor?:No
Enumeration Date:2021-04-16
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH33712207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology