Individual
DR. THEODORE W. LIEBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
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
Enumeration date
06/21/2007
Last updated
05/13/2008
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