Provider Demographics
NPI:1033515002
Name:LIEBERMAN, CHAVIE (CLD)
Entity Type:Individual
Prefix:
First Name:CHAVIE
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:CLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 COURTENAY RD
Mailing Address - Street 2:
Mailing Address - City:HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11550-4647
Mailing Address - Country:US
Mailing Address - Phone:516-483-1362
Mailing Address - Fax:
Practice Address - Street 1:100 COURTENAY RD
Practice Address - Street 2:
Practice Address - City:HEMPSTEAD
Practice Address - State:NY
Practice Address - Zip Code:11550-4647
Practice Address - Country:US
Practice Address - Phone:516-483-1362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-18
Last Update Date:2014-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula