Healthcare Provider Details

I. General information

NPI: 1992877807
Provider Name (Legal Business Name): ERNEST LIEBER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 EAST 149TH ST
BRONX NY
10451
US

IV. Provider business mailing address

144 EAST 36TH ST
NEW YORK CITY NY
10016
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5000
  • Fax: 718-579-4700
Mailing address:
  • Phone: 212-685-4695
  • Fax: 718-579-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number097702
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: