Provider Demographics
NPI:1023216025
Name:LIEBERMANN, YAFFA (PT)
Entity Type:Individual
Prefix:MRS
First Name:YAFFA
Middle Name:
Last Name:LIEBERMANN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MALKE DR
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3370
Mailing Address - Country:US
Mailing Address - Phone:732-859-9640
Mailing Address - Fax:
Practice Address - Street 1:32 LAUREL AVE
Practice Address - Street 2:
Practice Address - City:KEANSBURG
Practice Address - State:NJ
Practice Address - Zip Code:07734-1125
Practice Address - Country:US
Practice Address - Phone:732-787-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA003706002251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics