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General NPI Number Information
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NPI Number | 1669979316
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Entity Type | Individual
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Provider Name | PHILIP LIEBERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 04/10/2018
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Last Update Date | 06/01/2026
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Provider Practice Location Address
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Address Line | 295 OLD EAGLE SCHOOL RD
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City | WAYNE
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State | PA
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Zip | 19087-2609
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Country | US
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Telephone | 215-645-7044
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Fax |
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Provider Business Mailing Address
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Address Line | 295 OLD EAGLE SCHOOL RD
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City | WAYNE
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State | PA
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Zip | 19087-2609
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Country | US
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Telephone |
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD491172
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License Number State | PA
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