Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0216X | Pediatric Rheumatologist | 25MA10787900 | NJ |
Y | 2080P0216X | Pediatric Rheumatologist | MD460973 | PA |
NPI | 1659764538 |
---|---|
Provider Name | Emily Liebling |
First Address | Philadelphia, PA 19104 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2015 |
Last Update Date | 20/04/2020 |