Dr Nicholas Liberty, DDS is a
Student In An Organized Health Care Education/training Program based in Philadelphia, Pennsylvania. Dr Nicholas Liberty is licensed to practice in Pennsylvania (license number DS044751) and his current practice location is
3223 N Broad St, Philadelphia, Pennsylvania. He can be reached at his office (for appointments etc.) via phone at
(215) 707-2900.
NPI number for Dr Nicholas Liberty is 1063198513 and his current mailing address is 124 Teceira Way, Folsom, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1063198513.
Healthcare Provider's Profile
| Full Name | Dr Nicholas Liberty |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 3223 N Broad St, Philadelphia, Pennsylvania |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1063198513
- Provider Enumeration Date: 06/27/2023
- Last Update Date: 06/27/2024
Medical Identifiers
Medical identifiers for Dr Nicholas Liberty such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063198513 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 110187 (California) | Secondary |
| 122300000X | Dentist | 2023025122 (Missouri) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | DS044751 (Pennsylvania) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Nicholas Liberty is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Nicholas Liberty, DDS
124 Teceira Way,
Folsom, CA 95630-7729
Ph: (916) 932-6037 | Dr Nicholas Liberty, DDS
3223 N Broad St,
Philadelphia, PA 19140-5007
Ph: (215) 707-2900 |
Reviews and Comments