Provider Demographics
NPI:1417952714
Name:LIBMAN, VALERIY (DDS)
Entity Type:Individual
Prefix:DR
First Name:VALERIY
Middle Name:
Last Name:LIBMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TRUMAN DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1128
Mailing Address - Country:US
Mailing Address - Phone:212-365-4157
Mailing Address - Fax:
Practice Address - Street 1:2208 GEORGES RD # US130
Practice Address - Street 2:
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-4805
Practice Address - Country:US
Practice Address - Phone:732-276-4866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2021-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0494351223G0001X
NJ22DI027273001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02177517Medicaid