Organization
PETER S. LIEBERT MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER S LIEBERT M.D. (PRESIDENT)
(914) 428-3533
Entity
Organization
Contact information
Practice address
222 WESTCHESTER AVENUE, SUITE 403, WHITE PLAINS, NY 10604
(914) 428-3533
(914) 946-8766
Mailing address
222 WESTCHESTER AVENUE, SUITE 403, WHITE PLAINS, NY 10604
(914) 428-3533
(914) 946-8766
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
093575
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00607570
—
NY
01
—
4267440
AETNA US HEALTHCARE
—
01
—
52A061
BCBS
—
01
—
WS245
OXFORD
—
Enumeration date
10/25/2011
Last updated
10/25/2011
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