Healthcare Provider Details

I. General information

NPI: 1164579462
Provider Name (Legal Business Name): LIEBA SAVITT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 01/05/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 CONCORD AVE STE 3300
CAMBRIDGE MA
02138-1040
US

IV. Provider business mailing address

725 CONCORD AVE STE 3300
CAMBRIDGE MA
02138-1040
US

V. Phone/Fax

Practice location:
  • Phone: 617-354-5452
  • Fax: 617-497-7503
Mailing address:
  • Phone: 617-354-5452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number261973
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: