Roger D. Lieberman, D.O.

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MB04048000 Issued in NJ

Legal business name

ROGER D. LIEBERMAN, D.O.

Practice address

1601 N 2ND St
Suite C4
Millville, NJ 08332-1924

Phone

(856) 327-2770

Fax

(856) 327-9686

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Mady Lieberman

Title

Office Manager

Phone

(856) 327-2770

Specialties & licenses 1

Addresses

Other identifiers 5

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1881644615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1128",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083328128",
            "telephone_number": "856-327-2770",
            "fax_number": "856-327-9686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N 2ND ST",
            "address_2": "SUITE C4",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083321924",
            "telephone_number": "856-327-2770",
            "fax_number": "856-327-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROGER D. LIEBERMAN, D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "MADY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-327-2770"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MB04048000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0575003",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4089909",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "0K0643",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "CBS048",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "0107916000",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Naomi Riley-Walker, RN
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• Tarena Rivera
• Francisco Rodriguez, PHARMD.
• Liwaya Rojas
• Jose R Ruiz, D.P.M.
• Azizeh J. Salloum, MD
• Lorraine Michelle Santucci, PHD RN APNC
• Randi Lynn Scott, PT

• Specialist in Millville, NJ
• Providers in Millville, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.