Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 224330 | MA |
Y | 2084N0402X | Child Neurologist | 224330 | MA |
NPI | 1134305071 |
---|---|
Provider Name | Dr. Jonathan Oren Lipton |
First Address | Boston, MA 02115 |
Second Address | Boston, MA 02115-5724 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2008 |
Last Update Date | 22/01/2015 |