Provider Demographics
NPI:1821030271
Name:LIEBERMAN, AMARA ASHJIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMARA
Middle Name:ASHJIAN
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1 BALA PLZ
Mailing Address - Street 2:SUITE 620
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1403
Mailing Address - Country:US
Mailing Address - Phone:610-664-3300
Mailing Address - Fax:610-664-1151
Practice Address - Street 1:1 BALA PLZ
Practice Address - Street 2:SUITE 620
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1403
Practice Address - Country:US
Practice Address - Phone:610-664-3300
Practice Address - Fax:610-664-1151
Is Sole Proprietor?:No
Enumeration Date:2006-06-11
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD057250L207ND0900X, 207N00000X, 207NI0002X, 207NP0225X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G12693Medicare UPIN
LI792792Medicare ID - Type Unspecified