Liebold, Ian M
Liebold, Ian M is an individual health care provider with primary practice located at 600 Commerce Blvd , Stroudsburg PA 18360-6214. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Liebold, Ian M can be contacted via phone (570) 424-7390.Contact Information
Primary practice address
600 Commerce Blvd
Stroudsburg PA 18360-6214
Phone: (570) 424-7390
Fax: (570) 424-7395
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | SP024724 | Pennsylvania |
Profile Details
| NPI number | 1265198030 |
|---|---|
| LBN Legal business name | Liebold, Ian M |
| Credentials | CRNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 16th, 2021 |
| Last updated | Jan 6th, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265198030 | NPPES |
| Pennsylvania | Other | SP024724 | STATE LICENSE |
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