Provider Demographics
NPI:1578613766
Name:LIEB, ROBERT CRAIG (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:CRAIG
Last Name:LIEB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 MORRISTOWN RD PLAZA 202 SUITE 203
Mailing Address - Street 2:
Mailing Address - City:BERNARDSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07924
Mailing Address - Country:US
Mailing Address - Phone:908-766-1000
Mailing Address - Fax:
Practice Address - Street 1:150 MORRISTOWN RD
Practice Address - Street 2:PLAZA 202 SUITE 203 IBC PA
Practice Address - City:BERNARDSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07924
Practice Address - Country:US
Practice Address - Phone:908-766-1000
Practice Address - Fax:908-766-0100
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ408002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
C56923Medicare UPIN
LI455432Medicare ID - Type Unspecified