Individual
JOHANNA OMARK LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2396
(718) 920-6506
Mailing address
3415 BAINBRIDGE AVE, BRONX, NY 10467-2403
(718) 741-2396
(718) 920-6506
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
—
—
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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