Provider Demographics
NPI:1043369713
Name:LEIBOWITZ, EUGENE W (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:W
Last Name:LEIBOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 NORTHBROOK LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-9118
Mailing Address - Country:US
Mailing Address - Phone:413-445-5427
Mailing Address - Fax:
Practice Address - Street 1:510 NORTH ST
Practice Address - Street 2:OFFICE 4-B
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4111
Practice Address - Country:US
Practice Address - Phone:413-445-5427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA35619207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery