Active NPI
Edward Paul Liebmann
- Psychologist
- West Haven, CT
National Provider Identifier
1164044434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 950 Campbell Ave
West Haven, CT 06516-2770 - Phone
- (203) 932-5711
- NPI assigned
- May 10, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | Primary |
Addresses
Primary practice location
950 Campbell Ave
West Haven, CT 06516-2770
Mailing address
103 E 75TH St Apt 9FW
New York, NY 10021-2805
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241216002008 | NY | Order and Referring Only - Clinical Psychologist | 1658807516 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024822 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589068800000",
"number": "1164044434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 E 75TH ST APT 9FW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100212805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 CAMPBELL AVE",
"city": "WEST HAVEN",
"state": "CT",
"postal_code": "065162770",
"telephone_number": "203-932-5711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBMANN",
"first_name": "EDWARD",
"middle_name": "PAUL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-05-10",
"last_updated": "2020-05-10",
"certification_date": "2020-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.