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General NPI Number Information
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NPI Number | 1194762534
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Entity Type | Organization
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Legal Business Name | SOUTH JERSEY ENT ASSOCIATES
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 2835 S DELSEA DR SUITE D
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City | VINELAND
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State | NJ
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Zip | 08360-7079
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Country | US
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Telephone | 856-205-0800
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Fax | 856-205-0024
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Provider Business Mailing Address
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Address Line | 2835 S DELSEA DR SUITE D
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City | VINELAND
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State | NJ
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Zip | 08360-7079
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Country | US
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Telephone | 856-205-0800
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Fax | 856-205-0024
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Authorized Official
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Title or Position | M.D.
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Name | DR. EMIL P. LIEBMAN
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Credential | M.D.
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Telephone | 856-205-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State | NJ
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