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General NPI Number Information
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NPI Number | 1801887948
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Entity Type | Individual
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Provider Name | NORBERT J LIEBSCH MD PHD
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Gender | Male
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Dates
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Enumeration Date | 10/28/2005
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Last Update Date | 06/04/2010
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Provider Practice Location Address
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Address Line | 55 FRUIT ST YAW 1
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City | BOSTON
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State | MA
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Zip | 02114-2621
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Country | US
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Telephone | 617-724-1548
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Fax | 617-726-2098
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Provider Business Mailing Address
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Address Line | PO BOX 9142 MASS GENERAL PHYSICIAN ORGANIZATION
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City | CHARLESTOWN
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State | MA
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Zip | 02129-9142
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Country | US
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Telephone | 617-724-0287
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Fax | 617-726-2894
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 60408
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 60408
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License Number State | MA
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