Healthcare Provider Details

I. General information

NPI: 1265877609
Provider Name (Legal Business Name): SARA LIEBERT NY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PH
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

19 W 34TH ST PH
NEW YORK NY
10001-3006
US

V. Phone/Fax

Practice location:
  • Phone: 917-268-7665
  • Fax:
Mailing address:
  • Phone: 917-268-7665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number024376
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: