Provider Demographics
NPI:1740065895
Name:LIBRA MEDICAL LLC
Entity type:Organization
Organization Name:LIBRA MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KSENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZHURAVLEVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:848-404-4424
Mailing Address - Street 1:342 OAK KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3862
Mailing Address - Country:US
Mailing Address - Phone:848-404-4424
Mailing Address - Fax:
Practice Address - Street 1:342 OAK KNOLL DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3862
Practice Address - Country:US
Practice Address - Phone:848-404-4424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies