Provider Demographics
NPI:1457397770
Name:LIEBERMAN, DAVID NATHAN (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:NATHAN
Last Name:LIEBERMAN
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Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:300 LONGWOOD AVENUE
Mailing Address - Street 2:DEPARTMENT OF NEUROLOGY, FEGAN 11
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-3213
Mailing Address - Country:US
Mailing Address - Phone:617-355-2063
Mailing Address - Fax:617-730-0288
Practice Address - Street 1:300 LONGWOOD AVENUE
Practice Address - Street 2:DEPARTMENT OF NEUROLOGY, FEGAN 11
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115
Practice Address - Country:US
Practice Address - Phone:617-355-2063
Practice Address - Fax:617-730-0288
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2018-09-27
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Provider Licenses
StateLicense IDTaxonomies
MA2683062084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology