Provider Demographics
NPI:1801835590
Name:LIEBERMAN, BETH W (MD)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:W
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 LEGEND CT
Mailing Address - Street 2:
Mailing Address - City:WEST HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10604-1617
Mailing Address - Country:US
Mailing Address - Phone:914-328-2527
Mailing Address - Fax:212-689-7605
Practice Address - Street 1:333 E 30TH ST
Practice Address - Street 2:LOBBY OFFICE
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6416
Practice Address - Country:US
Practice Address - Phone:212-689-4468
Practice Address - Fax:212-689-7605
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY121256207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAL6301256OtherBNDD
NY121256OtherMEDICAL LICENSE
NYC08332Medicare UPIN
NY73P041Medicare ID - Type Unspecified