MEDICARE: DR. PIA L LIEB DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	041979	NY

General Provider Information

NPI Number	:	1568780765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PIA L LIEB DDS

Provider Business Mailing Address
First Line	:	381 PARK AVE S RM 908
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10016-8827
Country	:	US
Telephone Number	:	212-829-1515
Fax Number	:	212-804-8113

Provider Business Practice Location Address
First Line	:	381 PARK AVE S
Second Line	:	SUITE 904
City	:	NEW YORK
State	:	NY
Zip	:	10016-8806
Country	:	US
Telephone Number	:	212-829-1515
Fax Number	:	212-804-8113

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2010
Last Update Date	:	01/27/2025

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