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General NPI Number Information
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NPI Number | 1396844163
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Entity Type | Individual
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Provider Name | COLETTE D LIEBER MD
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Gender | Female
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 09/06/2010
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Provider Practice Location Address
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Address Line | 400 FRANKLIN TPK SUITE 208
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City | MAHWAH
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State | NJ
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Zip | 07430
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Country | US
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Telephone | 201-825-0009
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Fax | 201-825-2622
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Provider Business Mailing Address
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Address Line | 400 FRANKLIN TURNPIKE SUITE 208
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City | MAHWAH
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State | NJ
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Zip | 07430
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Country | US
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Telephone | 201-825-0009
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Fax | 201-825-2622
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 51951
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License Number State | NJ
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