Provider Demographics
NPI:1194762534
Name:SOUTH JERSEY ENT ASSOCIATES
Entity type:Organization
Organization Name:SOUTH JERSEY ENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIL
Authorized Official - Middle Name:P
Authorized Official - Last Name:LIEBMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-205-0800
Mailing Address - Street 1:2835 S DELSEA DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-7079
Mailing Address - Country:US
Mailing Address - Phone:856-205-0800
Mailing Address - Fax:856-205-0024
Practice Address - Street 1:2835 S DELSEA DR
Practice Address - Street 2:SUITE D
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-7079
Practice Address - Country:US
Practice Address - Phone:856-205-0800
Practice Address - Fax:856-205-0024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty