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General NPI Number Information
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NPI Number | 1447849765
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Entity Type | Individual
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Provider Name | BRAD SAMUEL LIEBERMAN NP
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Gender | Male
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 233 7TH ST STE 200
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City | GARDEN CITY
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State | NY
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Zip | 11530-5747
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Country | US
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Telephone | 516-737-0361
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Fax | 917-672-3491
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Provider Business Mailing Address
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Address Line | 233 7TH ST STE 200
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City | GARDEN CITY
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State | NY
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Zip | 11530-5747
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Country | US
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Telephone | 201-377-5122
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Fax | 917-672-3491
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 407830
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License Number State | NY
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