Bruce A Lieberman, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

113208 Issued in NY

Practice address

983 Park Avenue
New York, NY 10028-0808

Phone

(212) 737-5958

Fax

(201) 568-9781

NPI assigned

Apr 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 20, 2017 through Oct 20, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669692430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "983 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280808",
            "telephone_number": "212-737-5958",
            "fax_number": "201-568-9781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 PARK AVENUE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280808",
            "telephone_number": "212-737-5958",
            "fax_number": "201-568-9781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "113208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stefan Lieber, MD
• Alissa Michelle Lieberman, O.T.
• Amy Lieberman, LCSW
• Anna Lieberman
• Beth W. Lieberman, M.D.
• Charlotte Annie Lieberman
• Diane Axt Lieberman, PHD, RD ,CSR ,CDN
• Donna E Lieberman, PHD
• Dorothy Lieberman, M.D.
• Edward Joshua Lieberman, DDS

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.