Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 293982-01 | NY |
NPI | 1194119180 |
---|---|
Provider Name | Diane Liu |
First Address | New York, NY 10022-6102 |
Second Address | New York, NY 10021-4872 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2015 |
Last Update Date | 12/10/2021 |