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NPI Code Detail

MEDICARE: DR. TERRY DAVID LIEBMAN D.D.S.

MEDICARE: DR. TERRY DAVID LIEBMAN D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry036805NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1669519344
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TERRY DAVID LIEBMAN D.D.S.
Provider Business Mailing Address
First Line : 947 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-1623
Country : US
Telephone Number : 718-389-4266
Fax Number : 718-389-7259
Provider Business Practice Location Address
First Line : 947 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-1623
Country : US
Telephone Number : 718-389-4266
Fax Number : 718-389-7259
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 08/03/2012

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