Provider Demographics
NPI:1770809097
Name:LEIBU, EVAN (MD)
Entity type:Individual
Prefix:DR
First Name:EVAN
Middle Name:
Last Name:LEIBU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:387 PARK AVE S FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-8810
Mailing Address - Country:US
Mailing Address - Phone:212-401-1970
Mailing Address - Fax:917-809-6717
Practice Address - Street 1:136 MADISON AVE FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6795
Practice Address - Country:US
Practice Address - Phone:212-401-1970
Practice Address - Fax:917-809-6717
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2020-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2626352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry