Organization
ROGER D. LIEBERMAN, D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MADY LIEBERMAN (OFFICE MANAGER)
(856) 327-2770
Entity
Organization
Contact information
Practice address
1601 N 2ND ST, SUITE C4, MILLVILLE, NJ 08332-1924
(856) 327-2770
(856) 327-9686
Mailing address
PO BOX 1128, MILLVILLE, NJ 08332-8128
(856) 327-2770
(856) 327-9686
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MB04048000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0107916000
AMERIHEALTH
NJ
05
—
0575003
—
NJ
01
—
0K0643
HEALTH NET
NJ
01
—
4089909
AETNA
NJ
01
—
CBS048
OXFORD
NJ
Enumeration date
05/11/2006
Last updated
06/24/2008
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