Provider Demographics
NPI:1003934373
Name:LEIBOW, DAVID BARRY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:BARRY
Last Name:LEIBOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1225 PARK AVE
Mailing Address - Street 2:1S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1758
Mailing Address - Country:US
Mailing Address - Phone:212-531-3067
Mailing Address - Fax:212-665-1254
Practice Address - Street 1:1225 PARK AVE
Practice Address - Street 2:1S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1758
Practice Address - Country:US
Practice Address - Phone:212-531-3067
Practice Address - Fax:212-665-1254
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY1331152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry