Provider Demographics
NPI:1295713451
Name:LEIBEL, NATASHA (MD)
Entity type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:LEIBEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 SAINT NICHOLAS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3822
Mailing Address - Country:US
Mailing Address - Phone:212-851-5494
Mailing Address - Fax:212-851-5485
Practice Address - Street 1:1150 SAINT NICHOLAS AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3822
Practice Address - Country:US
Practice Address - Phone:212-851-5494
Practice Address - Fax:212-851-5485
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2174742080P0205X
NY217474-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02656215Medicaid
NYI33378Medicare UPIN
NY02656215Medicaid