Provider Demographics
NPI:1487659785
Name:LIBMAN, LYUBOV (DDS)
Entity type:Individual
Prefix:DR
First Name:LYUBOV
Middle Name:
Last Name:LIBMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 TRUMAN DR
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-1128
Mailing Address - Country:US
Mailing Address - Phone:212-365-4210
Mailing Address - Fax:
Practice Address - Street 1:67 STATE ROUTE 36
Practice Address - Street 2:
Practice Address - City:WEST LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07764-1432
Practice Address - Country:US
Practice Address - Phone:732-571-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02727200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02360016Medicaid