DR. GORDON SIDNEY LIEBERGALL (NPI# 1689653362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689653362 |
| Entity Type | Individual |
| Full Name | DR. GORDON SIDNEY LIEBERGALL |
| Credential | M.D. |
| Practice Address |
222 Route 59 Suite 207 Suffern NY 10901-5204 |
| Practice Telephone | 8453572500 |
| Practice Fax Number | 8453683937 |
| Mailing Telephone | 8453572500 |
| Mailing Fax Number | 8453683937 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 084611 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 00127838 | 05 | |
| NM | STATE MEDICAL LICENSE NUM | 084611 | 01 |
| Street Address |
222 ROUTE 59 SUITE 207 |
| City | SUFFERN |
| State | NY |
| Zip Code | 10901-5204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174526016 | Joel H Selter | Specialist | 222 Route 59, Ste 109, Suffern, NY 10901-5207 | 2005-05-24 |
| 1598279846 | Florence Bruckman | Behavioral Analyst | 222 Route 59, Suffern, NY 10901-5204 | 2017-11-23 |
| 1962809822 | Physical Medicine of Ramapo Pllc | Pain Medicine | 222 Route 59, Suite 106, Suffern, NY 10901-5207 | 2014-11-20 |
| 1053724708 | Katherine Townley | Physician Assistant | 222 Route 59, Suite 205, Suffern, NY 10901-5204 | 2014-06-10 |
| 1881945343 | Jessica Lauren Valle | Physician Assistant | 222 Route 59, Suite 109, Suffern, NY 10901-5204 | 2012-09-25 |
| 1194076646 | Chito A Oclarit | Physical Therapist | 222 Route 59, Suite #106, Suffern, NY 10901-5204 | 2012-09-24 |
| 1811253032 | Oluremi Williams | Nurse Practitioner | 222 Route 59, Suffern, NY 10901-5204 | 2012-04-02 |
| 1821383423 | Dipika Eila Rana | Pediatrics | 222 Route 59, Suite 306, Suffern, NY 10901-5204 | 2011-06-13 |
| 1245543776 | Ramapo Medical Services, PC | Physical Medicine & Rehabilitation | 222 Route 59, Suite 106, Suffern, NY 10901-5204 | 2010-07-26 |
| 1952626566 | James B. Israel, M.d., P.C. | Internal Medicine | 222 Route 59, Suite 105, Suffern, NY 10901-5207 | 2010-04-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740895309 | Constance Marie Princiotto | Registered Nurse | J&d Ultracare, 15 Suffern Pl, Suffern, NY 10901 | 2020-09-10 |
| 1376101790 | Tenika Filomena Walters | Licensed Practical Nurse | 15 Suffen Place, Suffen, NY 10901 | 2019-05-31 |
| 1922563261 | Matthew Abel | Dietitian, Registered | 156 Ny-59, A2, Suffern, NY 10901 | 2019-01-31 |
| 1609349422 | Yona Newmark | Behavioral Analyst | 84 Route 59 Suite 102, Suffern, NY 10901 | 2019-01-03 |
| 1235606005 | William M Mazariego | Specialist/Technologist | 5 Tallman Pl, Suffern, NY 10901 | 2018-10-30 |
| 1396237228 | Stephanie N Freer | Registered Nurse | 15 Suffern Pl., Suffern, NY 10901 | 2018-06-06 |
| 1588102669 | Lisa Arcuri | Registered Nurse | 15 Suffern Place Ste A, Suffern, NY 10901 | 2017-02-08 |
| 1801342787 | Maria Castro-cancel | Social Worker | 58 Campbell Avenue, Airmont, NY 10901 | 2016-08-30 |
| 1811341530 | Simone Raven Pringle | Licensed Practical Nurse | 15 Suffern Place, Suite A, Suffern, NY 10901 | 2016-04-19 |
| 1871998666 | Simi Samuel | Specialist | 13 Hillside Ct, Suffern, NY 10901 | 2014-10-23 |
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| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245487677 | Lance D. Redler M.d. PC | Ophthalmology | 11 North Airmont Road, Suffern, NY 10901 | 2008-08-27 |
| 1326249558 | Jeffrey M. Josef | Ophthalmology | 257 Lafayette Ave Ste 350, Suffern, NY 10901-4831 | 2007-05-28 |
| 1740360486 | Patrick Anthony Grisafi | Ophthalmology | 7 Hemion Road, Physicians and Surgeons Bldg, Suffern, NY 10901 | 2006-10-17 |
| 1598162521 | Rockland I-care | Ophthalmology | 257 Lafayette Ave, Suite 260, Suffern, NY 10901-4830 | 2014-11-19 |
| 1013269729 | Harold H. Weissman, M.d., P.C. | Ophthalmology | 12a N Airmont Rd, Suffern, NY 10901-5152 | 2012-10-04 |
| 1003116187 | B. Richard Nunziata, M.d., P.C. | Ophthalmology | 29 N Airmont Rd, Suffern, NY 10901-4242 | 2010-10-24 |
| 1225215031 | Samuel A Berger | Ophthalmology | 222 Route 59, Suite 207, Suffern, NY 10901-5204 | 2008-01-23 |
| 1194886614 | Harold H Weissman | Ophthalmology | 12a N Airmont Rd, Suffern, NY 10901-5105 | 2006-12-12 |
| 1053406314 | Bernard Richard Nunziata | Ophthalmology | 29 N Airmont Rd, Suffern, NY 10901-4242 | 2006-10-04 |
| 1144324179 | Joseph Richard Paskowski | Ophthalmology | 222 Route 59, Suite 207, Suffern, NY 10901-5204 | 2006-09-11 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.