Healthcare Provider Details

I. General information

NPI: 1598465189
Provider Name (Legal Business Name): GABRIELLE CATHERINE LIEBERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2023
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 OLD YORK RD
ABINGTON PA
19001-3720
US

IV. Provider business mailing address

63 PARRY WAY
IVYLAND PA
18974-2862
US

V. Phone/Fax

Practice location:
  • Phone: 215-481-2000
  • Fax:
Mailing address:
  • Phone: 732-856-0953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberF350567
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: