Individual
DEREK LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
877 STEWART AVE, GARDEN CITY, NY 11530-4803
(516) 745-0202
Mailing address
544 N LEWIS AVE, LINDENHURST, NY 11757-3536
(631) 245-2514
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01749
NY
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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