Provider Demographics
NPI:1467072447
Name:SIPIORA, JUSTIN EDMOND (MD)
Entity type:Individual
Prefix:
First Name:JUSTIN
Middle Name:EDMOND
Last Name:SIPIORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3509 N BROAD ST
Mailing Address - Street 2:BOYER SUITE 226
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19140-4105
Mailing Address - Country:US
Mailing Address - Phone:215-707-9837
Mailing Address - Fax:215-707-4721
Practice Address - Street 1:3509 N BROAD ST
Practice Address - Street 2:BOYER SUITE 226
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-4105
Practice Address - Country:US
Practice Address - Phone:215-707-9837
Practice Address - Fax:215-707-4721
Is Sole Proprietor?:No
Enumeration Date:2020-04-20
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY324719207R00000X
PAMT234255207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine