Provider Demographics
NPI:1093849127
Name:LIEBESKIND, ABRAHAM JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:JOSEPH
Last Name:LIEBESKIND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:130 2ND ST
Mailing Address - Street 2:NEONATOLOGY
Mailing Address - City:NEENAH
Mailing Address - State:WI
Mailing Address - Zip Code:54956-2883
Mailing Address - Country:US
Mailing Address - Phone:920-969-7990
Mailing Address - Fax:920-722-4224
Practice Address - Street 1:130 2ND ST
Practice Address - Street 2:NEONATOLOGY
Practice Address - City:NEENAH
Practice Address - State:WI
Practice Address - Zip Code:54956-2883
Practice Address - Country:US
Practice Address - Phone:920-969-7990
Practice Address - Fax:920-722-4224
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-12-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI444692080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1093849127Medicaid
WIE30983Medicare UPIN