Provider Demographics
NPI:1669798518
Name:LIEBERMAN, CHANA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHANA
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W SUNRISE HWY
Mailing Address - Street 2:TARGET PHARMACY T-1262
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-1001
Mailing Address - Country:US
Mailing Address - Phone:516-568-9275
Mailing Address - Fax:
Practice Address - Street 1:500 W SUNRISE HWY
Practice Address - Street 2:TARGET PHARMACY T-1262
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11581-1001
Practice Address - Country:US
Practice Address - Phone:516-568-9275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-18
Last Update Date:2010-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049899183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist