Liezl Villaverde, MD PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

210729 Issued in NY

Legal business name

LIEZL VILLAVERDE, MD PC

Practice address

105 Byrne Ave
Staten Island, NY 10314

Phone

(718) 698-7220

Fax

(718) 698-2004

NPI assigned

Sep 13, 2017

Organization subpart

Yes

Parent organization

LIEZL VILLAVERDE, MD PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Liezl Villaverde, MDNPI 1841386075

Title

President

Phone

(718) 698-7220

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Liezl Villaverde MD PC

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Liezl R Villaverde, MD

  • Pediatrics Physician
  • Staten Island, NY
  • NPI 1841386075
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1093234858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 BYRNE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-689-7220",
            "fax_number": "718-698-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 BYRNE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "10314",
            "telephone_number": "718-698-7220",
            "fax_number": "718-698-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIEZL VILLAVERDE, MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIEZL VILLAVERDE, MD PC",
        "enumeration_date": "2017-09-13",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "VILLAVERDE",
        "authorized_official_first_name": "LIEZL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-698-7220",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "210729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Howard Ira Allan Lieb, D.M.D.
• Dawn Lieberman, RN
• Gina Lieberman
• Ruth Lieberman, R.N, LMHC
• Elaine Liebman, MSED
• Life Skills Enhancement Occupational Therapy Services, PC
• Lifeline Imaging LLC
• Lifeline Pharmacy Incorporated
• Lifes Bounty Medical Care P C
• Lifespire, Inc.

• Pediatrics Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.