1902567704 NPI number — DR. DAVID GELIEBTER ED.D., NBC-HWC

Table of content: DR. DAVID GELIEBTER ED.D., NBC-HWC (NPI 1902567704)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902567704 NPI number — DR. DAVID GELIEBTER ED.D., NBC-HWC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GELIEBTER
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D., NBC-HWC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902567704
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1845 E 26TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11229-2437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-916-9059
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GERSHON (DUBENBOIM) ST. 44/1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEERSHEBA
Provider Business Practice Location Address State Name:
SOUHTERN DISTRICT
Provider Business Practice Location Address Postal Code:
8424004
Provider Business Practice Location Address Country Code:
IL
Provider Business Practice Location Address Telephone Number:
53-708-8769
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/04/2022

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171400000X , with the licence number:  A-3197113 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: A-3197113 . This is a "NATIONAL BOARD OF HEALTH & WELLNESS COACHES" identifier . This identifiers is of the category "OTHER".