Individual
LAWRENCE MARTIN LIEBLICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9 BROOKSITE DR, SMITHTOWN, NY 11787-3400
(631) 390-7800
(631) 390-7821
Mailing address
39 OLD COACH RD, EAST SETAUKET, NY 11733-3818
(631) 821-4789
(631) 689-6821
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
135570
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770021
—
NY
01
—
11-2644403
EMPIRE PLAN
NY
01
—
218790P
HIP
NY
01
—
218791P
HIP
NY
01
—
68A30
EMPIRE BCBS
NY
01
—
AJ48951
MDNY
NY
Enumeration date
08/04/2006
Last updated
12/08/2023
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