Basic Information
| Provider Information | |||||||||
| NPI: | 1184600371 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LIEBLING | ||||||||
| FirstName: | ANNE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 GERMANTOWN ROAD FLOOR 1 | ||||||||
| Address2: | DANBURY RHEUMATOLOGY FLOOR 1 | ||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037945600 | ||||||||
| FaxNumber: | 9142421516 | ||||||||
| Practice Location | |||||||||
| Address1: | 33 GERMANTOWN ROAD | ||||||||
| Address2: | FLOOR 1 | ||||||||
| City: | DANBURY | ||||||||
| State: | CT | ||||||||
| PostalCode: | 06810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2037945600 | ||||||||
| FaxNumber: | 9142421516 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/20/2005 | ||||||||
| LastUpdateDate: | 06/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RR0500X | 191581 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 037642 | CT | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 02179995 | 05 | NY | MEDICAID |