Organization Name: | LIBERTY BROTHERS INC |
NPI Number: | 1902175409 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | IDA LIBERZON (PRSEIDENT) |
Mailing Address: | 15137 Hartsook St Sherman Oaks |
State: | CA US |
Postal Code: | 914031207 |
Phone Number: | 3104988405 |
Fax Number: | |
NPI Enumeration Date: | 12/29/2011 |
NPI Last Update Date: | 12/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 293D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Laboratories |
Taxonomy Classification: | Physiological Laboratory |
Taxonomy Specialization: | |
Taxonomy Definition: | A laboratory that operates independently of a hospital and physician |