Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 44469 | WI |
NPI | 1093849127 |
---|---|
Provider Name | Dr. Abraham Joseph Liebeskind |
First Address | Neenah, WI 54956-2883 |
Second Address | Neenah, WI 54956-2883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 06/12/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1093849127 | (05) | WI |
E30983 | (02) | WI |