Provider Demographics
NPI:1821347360
Name:LIEBERMAN, ESTHER N
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:N
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 KING STREET
Mailing Address - Street 2:
Mailing Address - City:HILLSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07205
Mailing Address - Country:US
Mailing Address - Phone:917-940-6277
Mailing Address - Fax:
Practice Address - Street 1:28 KING STREET
Practice Address - Street 2:
Practice Address - City:HILLSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07205
Practice Address - Country:US
Practice Address - Phone:917-940-6277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582737051174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist