Provider Demographics
NPI:1699080267
Name:LIEBMAN, CATHERINE ALANNA (DO)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ALANNA
Last Name:LIEBMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 MARKET ST
Mailing Address - Street 2:9TH FL
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5548
Mailing Address - Country:US
Mailing Address - Phone:215-662-8777
Mailing Address - Fax:215-243-4601
Practice Address - Street 1:3737 MARKET ST FL 9
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5545
Practice Address - Country:US
Practice Address - Phone:215-662-8777
Practice Address - Fax:215-243-4601
Is Sole Proprietor?:No
Enumeration Date:2010-08-08
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0161782084N0008X, 207Q00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA299776YUNMMedicare PIN
NJ469943ZPCNMedicare PIN
PA299776YEBKMedicare PIN