Provider Demographics
NPI:1730270224
Name:SAUL LIPSMAN DPM MD PA
Entity type:Organization
Organization Name:SAUL LIPSMAN DPM MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:SAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:561-624-3338
Mailing Address - Street 1:4360 NORTHLAKE BLVD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-624-3338
Mailing Address - Fax:561-624-9629
Practice Address - Street 1:4360 NORTHLAKE BLVD
Practice Address - Street 2:SUITE 115
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-624-3338
Practice Address - Fax:561-624-9629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL94829OtherBLUE SHIELD
FL94829OtherBLUE SHIELD
K4962Medicare PIN