Provider Demographics
NPI:1669418745
Name:LIEBREICH, MARK (MD)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:
Last Name:LIEBREICH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 UNIVERSITY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-1873
Mailing Address - Country:US
Mailing Address - Phone:215-946-1500
Mailing Address - Fax:215-946-3417
Practice Address - Street 1:657 HEACOCK RD
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-6338
Practice Address - Country:US
Practice Address - Phone:215-750-7150
Practice Address - Fax:215-701-0913
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044551E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30165548OtherKEYSTONE FIRST
PA3266287OtherCIGNA PA
PA626085OtherHIGHMARK BLUE SHIELD
PA0014906860006Medicaid
PA0455758000OtherKEYSTONE IBC
PA4218757OtherAETNA
PAP01193815OtherRAILROAD MEDICARE
PA0014906860006Medicaid
PA30165548OtherKEYSTONE FIRST