Dr. Kenneth V Lieberman
Pediatric Nephrologist
30 Prospect Ave Humc - Pediatric Center
Hackensack
, New Jersey 07601-1914
Dr. Kenneth V Lieberman
Pediatric Nephrologist
30 Prospect Ave Humc - Pediatric Center
Hackensack
, New Jersey 07601-1914
(551) 996-5397
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About
Features
Specialties
- Pediatric Nephrologist
Languages spoken
- English
Location
First Address
- Dr. Kenneth V Lieberman
- 30 Prospect Ave
- Hackensack, NJ
- Zip : 07601-1915
- Fax : (551) 996-5397
- Phone : (551) 996-8228
Second Address
- Dr. Kenneth V Lieberman
- 30 Prospect Ave Humc - Pediatric Center
- Hackensack, NJ
- Zip : 07601-1914
- Fax : (551) 996-5397
- Phone : (551) 996-8228
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080P0210X | Pediatric Nephrologist | 25MA07270700 | NJ |
National Provider Identifier
| NPI | 1174582951 |
|---|---|
| Provider Name | Dr. Kenneth V Lieberman |
| First Address | Hackensack, NJ 07601-1915 |
| Second Address | Hackensack, NJ 07601-1914 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/03/2006 |
| Last Update Date | 07/03/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00634193 046 | (05) | NY |
| 051590DHK | PIN (01) | |
| 0923702 | (05) | NJ |
| B13704 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.