Provider Demographics
NPI:1043663644
Name:LIEBER, RONALD OKUAKI (LP)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:OKUAKI
Last Name:LIEBER
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 E 12TH ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-4623
Mailing Address - Country:US
Mailing Address - Phone:646-729-4314
Mailing Address - Fax:
Practice Address - Street 1:31 E 12TH ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4623
Practice Address - Country:US
Practice Address - Phone:646-729-4314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19000287102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst