Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 179480 | NY |
Y | 208600000X | Surgeon | 179480 | NY |
N | 2086S0102X | Surgical Critical Care | 179480 | NY |
NPI | 1326061045 |
---|---|
Provider Name | Dr. George Nicholas Liberis |
First Address | New City, NY 10956-4132 |
Second Address | New City, NY 10956-4132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 24/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01488182 | (05) | NY |
F87058 | (02) | NY |