Healthcare Provider Details

I. General information

NPI: 1194031088
Provider Name (Legal Business Name): SYLVIA BONNIE LIEBERS MS CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2010
Last Update Date: 08/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1070 LAMPLIGHTER RD
SCHENECTADY NY
12309-1162
US

IV. Provider business mailing address

PO BOX 9205
SCHENECTADY NY
12309-0205
US

V. Phone/Fax

Practice location:
  • Phone: 888-260-6543
  • Fax: 888-204-5975
Mailing address:
  • Phone: 518-370-4363
  • Fax: 518-370-4348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: