Healthcare Provider Details
I. General information
NPI: 1740228030
Provider Name (Legal Business Name): JOANNE ELAINE LIEGNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
179 HIGH ST
NEWTON NJ
07860
US
IV. Provider business mailing address
179 HIGH ST
NEWTON NJ
07860
US
V. Phone/Fax
- Phone: 973-383-4500
- Fax: 973-383-8943
- Phone: 973-383-4500
- Fax: 973-383-8943
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207V00000X |
| Taxonomy | Obstetrics & Gynecology Physician |
| License Number | MA046185 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: