Provider Demographics
NPI:1447259478
Name:LIPSON, CHERYL SANDRA (MD)
Entity type:Individual
Prefix:
First Name:CHERYL
Middle Name:SANDRA
Last Name:LIPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 DELAWARE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071-1858
Mailing Address - Country:US
Mailing Address - Phone:610-826-6353
Mailing Address - Fax:610-826-6359
Practice Address - Street 1:218 DELAWARE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071-1858
Practice Address - Country:US
Practice Address - Phone:610-826-6353
Practice Address - Fax:610-826-6359
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-20
Last Update Date:2022-06-01
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-27
Provider Licenses
StateLicense IDTaxonomies
PAMD037243E207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALI101650OtherBLUE SHIELD IDIV.NUMBER
PA002660OtherFIRST PRIORITY HEALTH
PA02292600OtherCAPITAL BLUE CROSS GRP. #
PA001258810Medicaid
PA001642680Medicaid
PA390004526OtherRAILROAD MEDICARE ID. NUM
PACA869935OtherBLUE SHIELD GRP. NUMBER
PAP1607796OtherOXFORD HEALTH PLAN
PA01046401OtherCAPITAL BLUE CROSS ID.
PA020286200OtherFEDERAL BLACK LUNG
PACE2338OtherRAILROAD MEDICARE GRP.NUM
PA390004526OtherRAILROAD MEDICARE ID. NUM
PA001642680Medicaid
PACE2338OtherRAILROAD MEDICARE GRP.NUM