Individual provider Active NPI

Angelene Lieberman, FNP

  • Family Nurse Practitioner
  • Woodbury, NY
National Provider Identifier
1932094729
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
357070 Issued in NY
Practice address
116 Woodbury Rd
Woodbury, NY 11797-1407
Phone
(516) 888-1224
Fax
(516) 224-4240
NPI assigned
Jun 11, 2025
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 357070 NY Primary

Addresses

Primary practice location

116 Woodbury Rd
Woodbury, NY 11797-1407

Mailing address

116 Woodbury Rd
Woodbury, NY 11797-1407
Phone (631) 464-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
357070NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Roessner Group Inc CurrentSince Nov 9, 2025 Accepting new patients

Locations

116 Woodbury Rd
Woodbury, NY 11797
Phone (516) 888-1224

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1932094729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971407",
            "telephone_number": "631-464-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WOODBURY RD",
            "city": "WOODBURY",
            "state": "NY",
            "postal_code": "117971407",
            "telephone_number": "516-888-1224",
            "fax_number": "516-224-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "ANGELENE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "357070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.