Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 1422 | OR |
NPI | 1063423937 |
---|---|
Provider Name | Dr. Brett J Lieberman |
First Address | Middletown, CT 06457-2510 |
Second Address | Middletown, CT 06457-2510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 08/07/2007 |