Organization
THEODORE W LIEBERMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THEODORE W LIEBERMAN MD (PRESIDENT OF CORPORATION)
(212) 722-5477
Entity
Organization
Contact information
Practice address
70 E 96TH ST, 1B, NEW YORK, NY 10128-0747
(212) 722-5477
(212) 722-5599
Mailing address
70 E 96TH ST, 1B, NEW YORK, NY 10128-0747
(212) 722-5477
(212) 722-5599
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
083922
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00125755
—
NY
01
—
5C5092
HEALTHYNET
—
01
—
NS3039
OXFORD
—
Enumeration date
08/09/2006
Last updated
05/14/2008
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