Healthcare Provider Details

I. General information

NPI: 1396072328
Provider Name (Legal Business Name): HANA LIEBOWITZ DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2009
Last Update Date: 11/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 E 57TH ST
NEW YORK NY
10022-2102
US

IV. Provider business mailing address

1255 5TH AVE SUITE 6L
NEW YORK NY
10029-3852
US

V. Phone/Fax

Practice location:
  • Phone: 212-753-4767
  • Fax: 212-753-4076
Mailing address:
  • Phone: 914-400-1500
  • Fax: 914-478-8781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number032077
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: