Provider Demographics
NPI:1174838874
Name:LEIBU, OLGA (MD)
Entity Type:Individual
Prefix:DR
First Name:OLGA
Middle Name:
Last Name:LEIBU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:OLGA
Other - Middle Name:
Other - Last Name:SVETNIKOV
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:136 MADISON AVE FL 6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6795
Mailing Address - Country:US
Mailing Address - Phone:212-901-6916
Mailing Address - Fax:917-809-6716
Practice Address - Street 1:136 MADISON AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6795
Practice Address - Country:US
Practice Address - Phone:212-901-6916
Practice Address - Fax:917-809-6716
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2652722084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry