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Individual

ALICE B GOTTLIEB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
336 ROUTE 202 STE 2, SOMERS, NY 10589-3221
(146) 178-9509
(914) 617-8960
Mailing address
51 TWIN LAKES RD, SOUTH SALEM, NY 10590-1012
(732) 589-2328

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
227191
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01040766
NY
01
028898
CT LICENCE
CT
01
146528
NY STATE LICENCE
NY
Enumeration date
05/04/2006
Last updated
06/25/2018
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