Basic Information
Provider Information
NPI: 1396072328
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIEBOWITZ
FirstName: HANA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1255 5TH AVE
Address2: SUITE 6L
City: NEW YORK
State: NY
PostalCode: 100293852
CountryCode: US
TelephoneNumber: 9144001500
FaxNumber: 9144788781
Practice Location
Address1: 139 E 57TH ST
Address2:  
City: NEW YORK
State: NY
PostalCode: 100222102
CountryCode: US
TelephoneNumber: 2127534767
FaxNumber: 2127534076
Other Information
ProviderEnumerationDate: 11/12/2009
LastUpdateDate: 11/12/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X032077NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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