Provider Demographics
NPI:1629680509
Name:PHILIP ANDREW LIBBY PSYCHOANALYSIS PC
Entity Type:Organization
Organization Name:PHILIP ANDREW LIBBY PSYCHOANALYSIS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOANALYST
Authorized Official - Prefix:PROF
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:LIBBY
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:732-543-5112
Mailing Address - Street 1:104 CEDAR LN APT B
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-2090
Mailing Address - Country:US
Mailing Address - Phone:632-543-5112
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:732-630-6920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalystGroup - Single Specialty