Basic Information
Provider Information
NPI: 1992877807
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LIEBER
FirstName: ERNEST
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 144 EAST 36TH ST
Address2:  
City: NEW YORK CITY
State: NY
PostalCode: 10016
CountryCode: US
TelephoneNumber: 2126854695
FaxNumber: 7185794640
Practice Location
Address1: 234 EAST 149TH ST
Address2:  
City: BRONX
State: NY
PostalCode: 10451
CountryCode: US
TelephoneNumber: 7185795000
FaxNumber: 7185794700
Other Information
ProviderEnumerationDate: 11/15/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207SG0201X097702NYY Allopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)

No ID Information.


Home