Provider Demographics
NPI:1538488747
Name:LIEBERMAN-KRAUS, NANCI (PT)
Entity Type:Individual
Prefix:
First Name:NANCI
Middle Name:
Last Name:LIEBERMAN-KRAUS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 GOLDENS BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-2810
Mailing Address - Country:US
Mailing Address - Phone:914-232-3306
Mailing Address - Fax:914-232-4862
Practice Address - Street 1:190 GOLDENS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-2810
Practice Address - Country:US
Practice Address - Phone:914-232-3306
Practice Address - Fax:914-232-4862
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003029-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist