Lieb Family Practice Inc | |
188 Industrial Park Rd Ste B Ebensburg PA 15931-4125 | |
(814) 419-8211 | |
(814) 846-5945 |
Full Name | Lieb Family Practice Inc |
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Speciality | Family Medicine |
Location | 188 Industrial Park Rd Ste B, Ebensburg, Pennsylvania |
Authorized Official Name and Position | Brian Lieb (OWNER) |
Authorized Official Contact | 8144198211 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Lieb Family Practice Inc 203 Forest Ln Carrolltown PA 15722-8819 Ph: (814) 659-7309 | Lieb Family Practice Inc 188 Industrial Park Rd Ste B Ebensburg PA 15931-4125 Ph: (814) 419-8211 |
NPI Number | 1104482587 |
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Provider Enumeration Date | 05/12/2019 |
Last Update Date | 02/01/2020 |
Medicare PECOS PAC ID | 5092148114 |
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Medicare Enrollment ID | O20191204000590 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104482587 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Brian E Lieb |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1871598268 PECOS PAC ID: 3577457613 Enrollment ID: I20050525000143 |
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