Provider Demographics
NPI:1063423937
Name:LIEBERMAN, BRETT J (ND)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:J
Last Name:LIEBERMAN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:87 BERNIE OROURKE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-2510
Mailing Address - Country:US
Mailing Address - Phone:860-347-8600
Mailing Address - Fax:860-347-8434
Practice Address - Street 1:87 BERNIE OROURKE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-2510
Practice Address - Country:US
Practice Address - Phone:860-347-8600
Practice Address - Fax:860-347-8434
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1422175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath