Provider Demographics
NPI:1598465189
Name:LIEBERMAN, GABRIELLE CATHERINE
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:CATHERINE
Last Name:LIEBERMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PARRY WAY
Mailing Address - Street 2:
Mailing Address - City:IVYLAND
Mailing Address - State:PA
Mailing Address - Zip Code:18974-2862
Mailing Address - Country:US
Mailing Address - Phone:732-856-0953
Mailing Address - Fax:
Practice Address - Street 1:1200 OLD YORK RD
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:PA
Practice Address - Zip Code:19001-3720
Practice Address - Country:US
Practice Address - Phone:215-481-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-03
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF350567363LN0005X
374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care