Jonathan Liebman
Nurse Practitioner - Community Health
58 Old North Rd
Worthington
, Massachusetts 01098-9753
Jonathan Liebman
Nurse Practitioner - Community Health
58 Old North Rd
Worthington
, Massachusetts 01098-9753
(413) 238-5358
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About
Features
Specialties
- Nurse Practitioner - Community Health
Languages spoken
- English
Location
First Address
- Jonathan Liebman
- 58 Old North Rd
- Worthington, MA
- Zip : 01098-9753
- Fax : (413) 238-5358
- Phone : (413) 238-5511
Second Address
- Jonathan Liebman
- 58 Old North Rd
- Worthington, MA
- Zip : 01098-9753
- Fax : (413) 238-5358
- Phone : (413) 238-5511
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC1500X | Nurse Practitioner - Community Health | 226054 | MA |
National Provider Identifier
| NPI | 1790755171 |
|---|---|
| Provider Name | Jonathan Liebman |
| First Address | Worthington, MA 01098-9753 |
| Second Address | Worthington, MA 01098-9753 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/01/2006 |
| Last Update Date | 06/02/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| NP1363 | BLUE CROSS BLUE SHIELD (01) | MA |
| S63952 | (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.