Provider Demographics
NPI:1558894949
Name:RIFKY LIEBERMAN LICENSED BEHAVIOR ANALYST PC
Entity Type:Organization
Organization Name:RIFKY LIEBERMAN LICENSED BEHAVIOR ANALYST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIFKY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:347-930-9736
Mailing Address - Street 1:11 BROOKVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6520
Mailing Address - Country:US
Mailing Address - Phone:347-930-9736
Mailing Address - Fax:845-746-9740
Practice Address - Street 1:4 BRIAR CT
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-6432
Practice Address - Country:US
Practice Address - Phone:347-930-9736
Practice Address - Fax:845-746-9740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-04
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty