Bridget Lieberum, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

022017 Issued in NY

Practice address

133 Aviation Rd
Queensbury, NY 12804-8206

Phone

(518) 798-0170

Fax

(518) 761-9538

NPI assigned

Mar 12, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• United Cerebral Palsy Association of the Tri-Counties, Inc.

  • Clinic/Center
  • Queensbury, NY
  • NPI 1952402448
  Medicare reassignment NPD

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

{
    "created_epoch": "1268352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1528381985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 AVIATION ROAD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048206",
            "telephone_number": "518-798-0170",
            "fax_number": "518-761-9538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 AVIATION RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128048206",
            "telephone_number": "518-798-0170",
            "fax_number": "518-761-9538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERUM",
        "first_name": "BRIDGET",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-03-12",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "022017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00752456",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francine Dominique Leo, LMHC-P
• Kyle S Leonard, MD
• Lewis Pediatric Dentistry PLLC
• Heather Lynn Lewis, OT
• David Bruce Lieberman, BA, MS, CAS
• Lifted Heart Mental Health Counseling, PLLC
• Sarah Lippert, CCC-SLP
• Lockhart Chiropractic, PC
• Lockhart Family Chiropractic, PC
• Kimberly Kay Lockhart, D.C.

• Physical Therapist in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.