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Individual

INGA LIBERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
4157 WASHINGTON ST, ROSLINDALE, MA 02131-1718
(617) 327-5600
(617) 327-5444
Mailing address
17 TANGLEWOOD RD, NEWTON, MA 02459-2849

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11357
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0311961
MA
Enumeration date
08/29/2006
Last updated
07/08/2007
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