Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 125061643 | IL |
N | 208600000X | Surgeon | 125061643 | IL |
Y | 2086X0206X | Surgical Oncologist | MT220691 | PA |
NPI | 1205199908 |
---|---|
Provider Name | Jason Bennet Liu |
First Address | Pittsburgh, PA 15201-2877 |
Second Address | Pittsburgh, PA 15213-2536 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2012 |
Last Update Date | 25/06/2020 |