Organization
BSL PM NJ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRAD SAMUEL LIEBERMAN APN (MEMBER)
(201) 314-1760
Entity
Organization
Contact information
Practice address
46 N CENTRAL AVE, RAMSEY, NJ 07446-1864
(201) 314-1760
Mailing address
31-09 HEYWOOD AVE, FAIR LAWN, NJ 07410-4405
(201) 314-1760
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/21/2021
Last updated
08/05/2024
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