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General NPI Number Information
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NPI Number | 1942443569
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Entity Type | Organization
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Legal Business Name | COMMUNITY RADIOLOGY OF ERIE, INC.
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Dates
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Enumeration Date | 04/13/2009
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 51 S MEADOW DR
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City | ORCHARD PARK
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State | NY
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Zip | 14127-2722
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Country | US
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Telephone | 716-481-4717
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Fax | 716-677-4299
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Provider Business Mailing Address
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Address Line | PO BOX 18005
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City | HAUPPAUGE
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State | NY
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Zip | 11788-8805
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Country | US
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Telephone | 631-517-8000
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Fax | 631-893-1923
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY LIEBERMAN
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Credential | M.D.
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Telephone | 716-481-4717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD418380
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License Number State | PA
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