Provider Demographics
NPI:1780422931
Name:LIEF, EUGENE (PHD, DABMP)
Entity type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:
Last Name:LIEF
Suffix:
Gender:M
Credentials:PHD, DABMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 WEST KINGSBRIDGE RD., RM GD-17
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468
Mailing Address - Country:US
Mailing Address - Phone:347-668-2420
Mailing Address - Fax:
Practice Address - Street 1:130 WEST KINGSBRIDGE RD., RM GD-17
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468
Practice Address - Country:US
Practice Address - Phone:347-668-2420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0001712085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics