Provider Demographics
NPI:1487312625
Name:LIEBOWITZ, ALAN (MSED)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:LIEBOWITZ
Suffix:
Gender:M
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CHARLES LINDBERGH BLVD STE 160
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-3653
Mailing Address - Country:US
Mailing Address - Phone:516-227-8635
Mailing Address - Fax:516-227-8663
Practice Address - Street 1:60 CHARLES LINDBERGH BLVD STE 160
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-3653
Practice Address - Country:US
Practice Address - Phone:516-227-8635
Practice Address - Fax:516-227-8663
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator