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General NPI Number Information
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NPI Number | 1487382206
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Entity Type | Organization
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Legal Business Name | TRISTATE PHYSICAL MEDICINE ASSOCIATES
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Dates
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Enumeration Date | 08/10/2022
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 317 W GERMANTOWN PIKE STE 102
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City | EAST NORRITON
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State | PA
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Zip | 19403-4278
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Country | US
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Telephone | 302-233-6916
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Fax | 484-631-1315
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Provider Business Mailing Address
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Address Line | 1000 N WEST ST STE 1200
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City | WILMINGTON
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State | DE
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Zip | 19801-1058
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Country | US
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Telephone | 302-233-6916
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Fax | 484-631-1315
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RONALD MICHAEL LIEBERMAN
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Credential | DO
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Telephone | 302-233-6916
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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