Healthcare Provider Details

I. General information

NPI: 1629207055
Provider Name (Legal Business Name): RANIT ADINA LIEBERMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2009
Last Update Date: 07/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3459 5TH AVE
PITTSBURGH PA
15213-3236
US

IV. Provider business mailing address

5624 FORBES AVE
PITTSBURGH PA
15217-1569
US

V. Phone/Fax

Practice location:
  • Phone: 412-677-6018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT019998
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: