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General NPI Number Information
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NPI Number | 1760692180
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Entity Type | Individual
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Provider Name | JARED J LIEBMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 5401 OLD YORK RD KLEIN 101
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City | PHILADELPHIA
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State | PA
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Zip | 19141-3030
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Country | US
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Telephone | 215-456-7890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8500-8735
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City | PHILADELPHIA
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State | PA
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Zip | 19178-8735
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Country | US
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Telephone | 215-456-7000
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD433333
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License Number State | PA
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