Healthcare Provider Details

I. General information

NPI: 1780858118
Provider Name (Legal Business Name): RACHEL LIEBMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 02/08/2022
Certification Date: 12/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COVENTRY DR
PHILLIPSBURG NJ
08865-1969
US

IV. Provider business mailing address

7500 KEVIN JOHNSON BLVD
BORDENTOWN NJ
08505
US

V. Phone/Fax

Practice location:
  • Phone: 908-454-9902
  • Fax: 908-454-9905
Mailing address:
  • Phone: 609-599-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MB09031400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: