Individual
DR. JESSE R. LIEBMAN
Active
Individual
DR. JESSE R. LIEBMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC.
Taxonomy
Speciality
Code
Description
License number
State
111NN1001X
Nutrition Chiropractor
Primary
38MC00423400
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2116578000
AMERIHEALTH
NJ
01
—
2664713
AETNA
NJ
01
—
P2705755
OXFORD
NJ
05
—
U35059
—
NJ
Enumeration date
01/12/2007
Last updated
09/28/2007
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