Provider Demographics
NPI:1467294694
Name:LIEBLER, KALEIGH (CGC)
Entity type:Individual
Prefix:
First Name:KALEIGH
Middle Name:
Last Name:LIEBLER
Suffix:
Gender:F
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SMITH HAVEN MALL STE 101
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-1219
Mailing Address - Country:US
Mailing Address - Phone:631-444-7885
Mailing Address - Fax:
Practice Address - Street 1:4 SMITH HAVEN MALL STE 101
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-1219
Practice Address - Country:US
Practice Address - Phone:631-444-7885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS