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Contact Information

OTTO LIEBMANN, MD
593 EDDY ST
CLAVERICK 2
PROVIDENCE, RI02903-4923
 Phone: 401-519-1604
 Fax: 401-272-0538
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for OTTO LIEBMANN · (Male)

NPI Number 1023039146
Status Active
Credentials MD
Entity Individual
Enumeration date 07/22/2006
Last updated 08/31/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • RI License # MD12526
  • MA Medicaid 2145464
  • RI Medicaid 2145464
  • Other P00671205 RAILROAD MEDICARE
  • MA Other 1/27/2009 TUFTS HEALTH PLAN
  • RI Other 414642 BCBSRI
  • RI Other 939025129 MEDICARE GROUP NUMBER
  • RI Other 12/13/2007 NHPRI
  • RI Other 1023039146 NPI
  • RI Other 007059786 RI MEDICARE
Hospital affiliation(s)
  • MIRIAM HOSPITAL - (Acute Care)
    164 SUMMIT AVENUE
    PROVIDENCE, RI 02906
  • RHODE ISLAND HOSPITAL - (Acute Care)
    593 EDDY STREET
    PROVIDENCE, RI 02902
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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