Healthcare Provider Details

I. General information

NPI: 1134348287
Provider Name (Legal Business Name): TARYN ANN LIEBERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BOYLSTON ST STE 320
CHESTNUT HILL MA
02467-1747
US

IV. Provider business mailing address

27 BOYLSTON ST STE 320
CHESTNUT HILL MA
02467-1747
US

V. Phone/Fax

Practice location:
  • Phone: 617-731-3400
  • Fax: 617-566-2224
Mailing address:
  • Phone: 617-731-3400
  • Fax: 617-566-2224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number222255
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number235177
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: