Healthcare Provider Details

I. General information

NPI: 1821139387
Provider Name (Legal Business Name): LIEBERMAN & LIEBERMAN OPTOMETRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 S 5TH ST
SAINT PAULS NC
28384-1741
US

IV. Provider business mailing address

327 S 5TH ST
SAINT PAULS NC
28384-1741
US

V. Phone/Fax

Practice location:
  • Phone: 910-865-9800
  • Fax:
Mailing address:
  • Phone: 910-865-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number StateNC

VIII. Authorized Official

Name: MS. JENNIFER GARRETT
Title or Position: OFFICE MGR
Credential:
Phone: 910-865-9800