Dr. Mark H Libenson
Pediatrician Child Neurologist
300 Longwood Ave Fegan 9
Boston
, Massachusetts 02115-5724
Dr. Mark H Libenson
Pediatrician Child Neurologist
300 Longwood Ave Fegan 9
Boston
, Massachusetts 02115-5724
(617) 730-0463
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About
Features
Specialties
- Pediatrician
- Child Neurologist
Languages spoken
- English
Location
First Address
- Dr. Mark H Libenson
- 300 Longwood Ave Fegan 9
- Boston, MA
- Zip : 02115-5724
- Fax : (617) 730-0463
- Phone : (617) 355-8071
Second Address
- Dr. Mark H Libenson
- 300 Longwood Ave Fegan 9
- Boston, MA
- Zip : 02115-5724
- Fax : (617) 730-0463
- Phone : (617) 355-8071
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 208000000X | Pediatrician | 60519 | MA |
| Y | 2084N0402X | Child Neurologist | 60519 | MA |
National Provider Identifier
| NPI | 1174541932 |
|---|---|
| Provider Name | Dr. Mark H Libenson |
| First Address | Boston, MA 02115-5724 |
| Second Address | Boston, MA 02115-5724 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 18/07/2006 |
| Last Update Date | 24/08/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3076580 | (05) | MA |
| E80807 | (02) | MA |
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.