National Provider Identifier

Jeffrey Lieberman

Jeffrey Lieberman is listed in the NPPES registry with a primary specialty of Diagnostic Radiology Physician in Orchard Park, NY and a listed phone number of (716) 677-6736.

NPI 1932109253Orchard Park, NYDiagnostic Radiology Physician

Profile Overview

NPI
1932109253
Provider Type
Individual
Primary Specialty
Diagnostic Radiology Physician
Enumeration Date
July 28, 2005
Last Updated
July 17, 2012

Practice Location

  • 3055 Southwestern Blvd
  • Suite 104
  • Orchard Park, NY 14127-1231

Phone: (716) 677-6736

Mailing Address

  • 51 S Meadow Dr
  • Orchard Park, NY 14127-2722

Specialties

  • Diagnostic Radiology Physician (2085R0202X)
Full Record
NPI
1932109253
Entity Type
Individual
Last Name
Lieberman
First Name
Jeffrey
Mailing Street Address
51 S Meadow Dr
Mailing City
Orchard Park
Mailing State
NY
Mailing ZIP Code
14127-2722
Mailing Country
US
Mailing Phone
(716) 662-0293
Mailing Fax
(716) 402-1862
Practice Street Address
3055 Southwestern Blvd
Practice Address Line 2
Suite 104
Practice City
Orchard Park
Practice State
NY
Practice ZIP Code
14127-1231
Practice Country
US
Practice Phone
(716) 677-6736
Practice Fax
(716) 677-6144
Enumeration Date
July 28, 2005
Last Updated
July 17, 2012
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Diagnostic Radiology Physician (2085R0202X)
Other Identifiers
00040819806 (Univera), 300136886 (NY, Railroad Medicare), P00420095 (Railroad Medicare), CRDRA1829183 (NY, Workers Compensation), 000523824010 (Blue Shield Of Western Ny), 208616656 (Fidelis), 01616022 (NY), 5608639 (Independant Health)