Individual
DR. KENNETH V LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30 PROSPECT AVE, HUMC - PEDIATRIC CENTER, HACKENSACK, NJ 07601-1914
(551) 996-8228
(551) 996-5397
Mailing address
30 PROSPECT AVE, HACKENSACK, NJ 07601-1915
(551) 996-8228
(551) 996-5397
Taxonomy
Speciality
Code
Description
License number
State
2080P0210X
Pediatric Nephrology Physician
Primary
25MA07270700
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00634193 046
—
NY
01
—
051590DHK
PIN
—
05
—
0923702
—
NJ
Enumeration date
03/21/2006
Last updated
09/30/2022
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