Doctor Name: | MR. ETHAN JOHN LIEBLER |
NPI Number: | 1770677809 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSPT |
License Number: | 22696 |
Business Practice Address: | 600 Northern Blvd 117 Great Neck, NY - 110215200 |
Business Phone Number: | 5164780014 |
Business Fax Number: | 5164873989 |
Mailing Address: | 56 Hemlock Dr, FARMINGDALE |
State: | NY |
Postal Code: | 117352929 |
Phone Number: | 5168525429 |
Fax Number: | 5162933829 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 22696 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |