Individual
DR. GORDON SIDNEY LIEBERGALL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 ROUTE 59, SUITE 207, SUFFERN, NY 10901-5204
(845) 357-2500
(845) 368-3937
Mailing address
222 ROUTE 59, SUITE 207, SUFFERN, NY 10901-5204
(845) 357-2500
(845) 368-3937
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
084611
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00127838
—
NY
01
—
084611
STATE MEDICAL LICENSE NUM
NM
Enumeration date
01/11/2006
Last updated
07/08/2007
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