Healthcare Provider Details

I. General information

NPI: 1033355920
Provider Name (Legal Business Name): LEAH PADAWER M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LEAH LIBERMAN

II. Dates (important events)

Enumeration Date: 12/23/2008
Last Update Date: 05/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

164 LAUREL PARK ROAD
FALLSBURG NY
12733-5041
US

IV. Provider business mailing address

164 LAUREL PARK ROAD
FALLSBURG NY
12733-5041
US

V. Phone/Fax

Practice location:
  • Phone: 845-436-9566
  • Fax: 845-436-9566
Mailing address:
  • Phone: 845-436-9566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number013323-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: