Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 285767 | NY |
N | 2080P0204X | Pediatric Emergency Doctor | 285767 | NY |
NPI | 1013318476 |
---|---|
Provider Name | Tian Liang |
First Address | Brooklyn, NY 11203-2054 |
Second Address | New York, NY 10016-6402 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2014 |
Last Update Date | 06/10/2020 |