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Individual
JONATHAN LIEBMAN
Active
Individual
JONATHAN LIEBMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LC1500X
Community Health Nurse Practitioner
Primary
226054
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NP1363
BLUE CROSS BLUE SHIELD
MA
Enumeration date
01/26/2006
Last updated
02/06/2015
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